Linda

When I recently heard about the FDA warning and read subsequent discussions
on lactnet, I decided to inform mothers of this risk, although it occurs
rarely.
Here is approximately what I say when talking about medication use while bf
or when moms (inevitably) ask about the safety of taking their pain meds
while bf:

"It's OK to take your pain medicine when you need it, as long as you don't
take more than what's been prescribed. There is a rare situation, where the
mother metabolizes the medicine differently, and it builds up and can build
up in the baby. I've never seen a case of this because it doesn't occur
often, but there have been cases of it reported The baby becomes too sleepy,
doesn't wake up to feed, and can be constipated. If you notice this with
your baby, you should call the doctor right away, and stop the pain
medicine. Any time a baby is not waking to feed it is a sign to call the
doctor anyway. And breastfed babies should have frequent bowel movements.
Most moms are taking the most pain medicine in the first few days, and this
is when the baby is taking in the least amounts of milk, so it usually is
not a problem. If you don't need the strong pain medicine, but you need
something, take an over the counter like Tylenol or Ibuprofen, or what's
recommended by your doctor."

I felt it was prudent to inform the mothers but not scare them
unnecessarily.

Laurie Wheeler, RN, MN, IBCLC
MISSISSIPPI USA

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