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Breastfeeding and Medications

It can be quite frustrating for breastfeeding mothers to find medications that are safe to take. This is because there is a lack of information available on whether certain drugs are safe to use while nursing, due to ethical reasons. However, before you decide to stop breastfeeding, there are ways to determine the potential risks a medication might pose to your nursing infant.

A Frustrating Lack of Information

In this day and age of modern medicine and abundant scientific research, you'd think we'd know just about everything concerning medication safety for breastfeeding women. However, the actual situation couldn't be more different. We know almost nothing about the safety of many medications during breastfeeding, even ones that are commonly used.
So what's a mother to do? Before you vow to avoid all medications, which is a common response to this issue in mothers, read this article to better understand how to find information and what to do when no information is available.

Research on Drugs and Breastfeeding

Quite often, women are frustrated to hear that no (or very little) information is available about the use of a particular drug during breastfeeding. They wonder if the scientific community just doesn't care about breastfeeding women and their babies. However, there is a very good reason why many medications have never been systematically studied in breastfeeding women -- it's typically unethical to do so.
In most situations, it's simply not ethical to expose a baby to the potential risks a drug presents, especially because babies cannot consent to the risks and will not directly benefit from the medication given to the breastfeeding mothers. The type of studies that give researchers the most valuable information (double-blind, placebo-controlled studies) almost always specifically exclude breastfeeding women, both for ethical as well as legal reasons. So where does information about medication use during breastfeeding come from?
There are a few common sources. In some cases, a woman and her healthcare provider decide on their own to use a medication during breastfeeding, even if the risks are unknown. If the woman consents, researchers might test her milk to see if the drug passes through to the milk and will also record any problems that occur in the baby.
In some types of studies, women who have decided not to breastfeed will consent to taking a dose of a medication shortly after the baby is born and to have their milk tested to see if it passes through breast milk; this prevents exposing the baby, who will not be breastfeeding.
Sometimes, information comes to light after a baby experiences problems that are thought to be the result of a medication the mother is taking. The doctors may test the baby and the milk to see how much of the medication the baby received. 
In general, there are a few basic types of information that can be obtained from research of medications used in breastfeeding women, such as:
  • How much of the medication passes through breast milk
  • How long the medication stays in the milk
  • The blood levels of the drug in both the mother and the infant
  • Any side effects that were seen in the infant.
Unfortunately, there is no standard rating or categorizing system for medication safety during breastfeeding as there is with pregnancy.
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