If the PDR is like its Canadian equivalent, there is no point in
looking in the PDR.  The information is coming from the pharmaceutical
companies and they are only interested in protecting themselves, not
mothers and children.  Thus, they will almost always say that the drug
is contraindicated during breastfeeding whether it is or not.  The AAP
list of drugs is easily obtained, and generally satisfactory, though I
have my disagreement with it too.

I hate to sound like a broken record, but mothers need to be empowered
to make the decisions on their own.  Thus, they need to know that
artificial baby milk is also a drug, very different in a multitude of
ways, from that which it is designed to replace, and has side effects,
like all drugs, some of which can be extremely serious.  It has been
said that not breastfeeding increases the risk of juvenile diabetes by
3 to 25%.  If there were a drug which increased the risk of diabetes
mellitus by 3%, it would not be on the market.  A drug for which there
was evidence that it increased the risk of lymphoma, would be
withdrawn from the market.

Thus the question of drugs and breastfeeding is, like everything we do
in life, a question of risk versus benefit.  If I were a breastfeeding
mother, I would not hesitate to take aspirin and continue
breastfeeding if I needed to take aspirin.

A plague on physicians who say never to take anything, no aspirin, no
nothing to breastfeeding women.  It is difficult enough to breastfeed
in our society (even LC's tell mothers they cannot have a single glass
a wine without "pumping and dumping"--AAARGH).  You're a breastfeeding
mother and you have a headache--tough luck, you "chose" to breastfeed,
now live with your headache and stop bothering me with your stupid
questions.  I never get questions like this from a formula feeding
mother.

The preceding was an unpaid political rant.

Jack Newman, MD, FRCPC