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Medications, pregnancy and breastfeeding

Originally posted April 10, 2017.

Did you know that 99% of women who stop breastfeeding due to medications can actually continue?

As a new mother 22 (short?) years ago, I suffered postpartum depression. I was breastfeeding and refused to take any medications for it. I think I would’ve come out of the depression sooner if I had opted for medication. But, I was afraid. There weren’t many studies back then. Now there are a lot of studies on this topic and there’s a lot of information available about medications and pregnancy and breastfeeding.

Depression is quite painful. People who are depressed are allowed to take medication to help their condition just as diabetics are. And, for both depression and diabetes, sometimes self-help techniques can augment treatment and reduce or eliminate the need for medication and sometimes self-help techniques just can’t.

Is it safe for you to take medications for your mental health while pregnant or breastfeeding?

If you have a condition for which you need medication for your mental health, the conundrum is that there is no option without zero risk: not taking the drug has risks and taking the drug has risks. Regarding cases of severe depression, anxiety and bipolar disease, the past 25 years of research shows that it’s better for mother and baby when mom takes her medication and becomes emotionally stable. You can weigh your options with your doctor and make an educated decision that’s right for you and your family.

Today, perinatal mental health is a psychiatric specialty. To find such a specialist might feel like looking for a needle in a haystack. Try calling Postpartum Support International’s (PSI) Warm Line. PSI has been an advocacy group for 25 years and has well-developed lists of perinatal resources by state. The warm line volunteer will connect you with the PSI representative in your state who is familiar with the resources in your local area.

If you’re like me, you’ll want to do some digging in addition to talking to your doctor. To read up on medications and mothers milk, there are several valid and reliable websites and apps which synthesize the copious research about pregnancy, breastfeeding and medications. These websites also have experts available you can talk with for free.

The Mother to Baby website is an organization maintained by teratogen specialists. It’s packed with information for both consumers and health care professionals backed by the latest research regarding medications, pregnancy and breastfeeding. Easy to understand Fact Sheets are available to read online and download about the actions of over the counter medication, prescription medications, alcohol, street drugs, and herbal products on pregnancy and lactation. Plus, live staff is available free of charge to answer your questions.

The Texas Tech School Medicine maintains two websites dedicated to education about medication safety and pregnancy and breastfeeding: the Infant Risk Center and Mommy Meds. This organization maintains a call center based solely on medicine and evidence based research regarding medications and supplements and pregnancy and breastfeeding.

The Infant Risk Center is slanted towards professionals. It was founded by Dr. Thomas Hale, a Professor of Pediatrics at Texas Tech School of Medicine. It’s expanded a lot over the years and is now maintained by Texas Tech University Health Sciences Center. Dr. Thomas Hale is the author of the well-known hefty (It’s1257 pages and weighs 2 1/2 pounds!) book, Medications and Mothers’ Milk: A Manual of Lactation Pharmacology. I actually owned a copy of this huge book for a very long time, but. like everything else, now there’s an app for that. :0)

Mommy Meds is the Infant Risk Center’s companion website for consumers. The information on this site is geared to consumers and is easy to navigate based on topic. For example, you can read an overview of Antidepressant Use During Pregnancy and Breastfeeding by Kathleen Kendall-Tackett, PhD. or about Hypothyroidism and Pregnancy by Lylla Ngo, M.D. and Thomas Hale, M.D.

Plus, there is an app for sale for consumers on this website called Mommy Meds – Pregnancy Safety Guide. I recycled the ginormous Hale book and purchased the consumers friendly Mommy Meds app and I’m happy with it. It has information on the safety of both prescription and over the counter medications and also on many vitamins and herbal supplements, for the pregnant or breastfeeding mother. I find it easy to navigate. On each substance page, at the top, it’s color coded to indicate the known risk of the substance in the first, second and third trimester and in breastfeeding.

Two other medication and pregnancy and breastfeeding informational websites that I highly recommend are Dr. Dr. Kathleen Kendall Tackett’s Breastfeeding Made Simple and Dr. Frank Nice’s website Nice Breastfeeding.

Dr. Kendall-Tackett is a legend in research and publication in her field of women’s mental health. She is a professor, researcher, trauma expert and certified lactation consultant, who has written numerous books and articles regarding women’s issues. Her book, Depression in New Mothers, is considered a seminal work in the postpartum depression field.

Dr. Nice is a pharmacist and researcher who worked for the National Institute of Health (NIH) for many years. His Nice Breastfeeding website has great educational information about the current thinking about medications and breastfeeding. He finds that many women give up breastfeeding due to fears about medication and this is not really necessary. He has a good article about herbal galactagogues and their dosage. Some of them are fennel, alfalfa and dandelion. He is now retired and has published two books meant to be companion books to Dr. Thomas Hale’s book and app. Non-Prescription Drugs for the Breastfeeding Mother is about OTC drug and herbal supplement safety while pregnant and breastfeeding. The Galactagogue Recipe Book is a collection of recipes which incorporate herbs known to support breastfeeding.

You must discuss your options about pregnancy, breastfeeding and medication with your doctor and together weigh the known risk factors, ultimately make the choice that is right for you and your family. As you can see, there is a wealth of free information available to you, to feed your decision making.

Some of the books discussed here in this blog are listed below.


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