Nice, Mr. Nice!
Holly McSpadden, IBCLC
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From: Lactation Information and Discussion <[log in to unmask]> on behalf of Frank J. Nice <[log in to unmask]>
Sent: Sunday, April 7, 2019 5:14:40 PM
To: [log in to unmask]
Subject: Letter to Editor NEJM
I submitted my letter to the Editor of the NEJM.
I only has 175 words to work with to do so.
I understand the odds against it getting published.
Also, I did use the words "breastfeeding" and breastfed."
Do not be surprised to see "breast feeding" and "breast fed" if the letter does get published.
Here is the content of my letter:
Safe can be defined as “protected from or not exposed to danger or risk; not likely to be harmed or lost.” Because a drug is not “safe” for breastfeeding does not mean the breastfed infant is protected or not exposed to danger or risk if the mom has to stop breastfeeding to take an “unsafe” drug. Compatible can be defined as “(of two things) able to exist or occur together without conflict.”
“Is it safe?” is not the question we should be asking regarding medication use during breastfeeding. The question we should be asking is “Is it compatible?” That question can be answered quite adequately by doing a proper benefit-risk analysis: Benefits of medication plus benefits of breastfeeding versus risks of medication plus risks of artificial formula.
I have been advising breastfeeding mothers and healthcare professionals for over 40 years on the use of medications during breastfeeding. For the vast majority of cases, we were able to answer the question as to whether a medication or an alternative medication was compatible with breastfeeding.
Frank J. Nice, RPh, DPA, CPHP
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