Posts Tagged ‘breastfeeding’

Pharmakokinetics are Fascinating!

Friday, July 23rd, 2010

When a person takes a drug their body absorbs the drug, breaks it down and then eliminates it. The study of this action is called pharmakokinetics. Why is this interesting for moms? Some drugs, even over-the-counter drugs are not good to take when you are pregnant or nursing. Some drugs are ok for nursing, but not pregnancy. How do doctors determine which drugs are ok?

There are reference books, to start with. One of the main reference books for nursing moms is called Medications and Mothers’ Milk by Dr. Thomas Hale. Dr. Hale is a pharmacist and a medical school professor and the publisher of my own book: Doulas’ Guide to Birthing Your Way.

Several factors help decide if a drug should not be taken by a nursing mom. Here are a few to keep in mind:

– Only about 1% of the mother’s dose reaches the baby through her breastmilk in many cases.

–If a mom has a condition which needs a drug, older drugs that have been on the market longer, are often safer than newer and less tested drugs are.

–The side effect that a mom gets from a drug is likely to be the side effect her baby will get (nausea or diarrhea for example).

– Smaller, premature or sicker babies tolerate drugs worse than healthy mature babies do.

–Keep in mind that just because a drug is over-the-counter, doesn’t make it safe for pregnant or nursing mothers.

–Most drugs will allow a mom to continue nursing or another drug can often be found to treat the condition which does!

–There are drugs which are considered safe for nursing moms which treat postpartum depression.

–When in doubt, call your La Leche League Leader or lactation consultant for help with a drug you are unsure of.

Doula to Doula — differences in 4 infant diseases

Thursday, July 22nd, 2010

Breastmilk is always best and babies can always tolerate their mother’s milk, right? Never say always! Below I describe four conditions which affect breastfeeding in babies. Here is how to understand them a bit better:

Galactosemia is a very rare condition which a baby has a genetic error and can not tolerate the build up of galactose in his system. Lactose is a double sugar made from  glucose + galactose. Lactose  is the main carbohydrate (sugar) in human milk. Babies with this very rare metabolic condition can not breastfeed! They must have medicines and special diets for the rest of their lives. Remember, I said it was very rare.

PKU is a rare genetic error in which the infant can’t handle the essential amino acid, phenylkentonuria (PKU). Amino acids are the building blocks of protein. Doctors have to manage the baby with medicine and diet. However, usually breastfeeding is OK.

Lactose Intolerance usually shows up after infancy. The person’s body becomes deficient in the enzyme lactase which breaks lactose into glucose and galactose. In some cultures this is fairly common. People  who have this need to avoid milk products or they experience bloating and gas. These people can breastfeed as babies! They don’t tend to have problems with nursing.

Cow’s Milk Protein Allergy is a relatively common condition that someone can grow into or out of. It usually happens after the baby is older than a newborn. It is an allergic reaction to a protein (betalactalbumin) in cow’s milk which is not present in breastmilk. Sometimes breastfed babies are affected by it. When that happens, mom takes cow’s milk out of her diet and this usually helps the baby’s colic.

Plastics and BPA a Guide

Tuesday, July 20th, 2010

The dizzying array of plastics on the shelf.

Plastic containers that moms use for children’s drinks or for storing pumped milk have become controversial. Moms all want to do what is best, if they can figure out what that is. Here is a basic guide regarding BPA’s.

BPA stands for bisphenol A. They  can leach into the liquid and are toxic. Avoid BPA’s. Here is how:

Polypropylene (milky white sturdy plastic and number 5 recycle sign) has no BPA’s and is OK!

Polystyrene (looks like cloudy plastic) has no BPA’s although it has other chemicals.

Polyethylene (flimsy and clear) no BPA’s but has other nasties.

Polycarbonate (looks clear and sturdy like glass) contains BPA’s.  Yuck! Avoid!

When you are looking for plastic milk storage bags, read the label and find out what the plastic is made out of. Be a good consumer! You don’t want to freeze your precious milk in a container which could cause your baby problems.

Slow Gaining Breastfed Baby

Thursday, July 1st, 2010

Nursing mothers are naturally concerned when their baby is slow to gain weight. Keep in mind that a newborn will often lose weight after their first weighing and gain start re-gaining the weight after your mature milk comes in (2-3 days after the birth). If you had IV fluids during your labor (as with an induction of labor or an epidural) some of your baby’s weight loss may be from fluid loss.

Once your baby has gotten back to birth weight, your doctor will be watching for weight gains. Check with your pediatrician or family doctor that the weight gain chart  being used is not one that tracks formula fed babies. Formula fed babies often gain weight sooner and Dr. Jack Newman questions whether this is good for the baby in the long run. Perhaps formula fed babies are gaining weight too fast? We don’t have enough long-term data to know, yet.

Meanwhile, make sure that you are nursing often and nursing several times during the night. Newborns and even older babies should not be sleeping through the night. If a baby does, he may not be getting enough to eat.

If your baby is active, vigorous and you offer your breast on demand (your baby’s demand, not yours) then your baby is probably just on her own weight-gain schedule. If you still have concerns, contact your local lactation consultant or La Leche League leader for help.

Breastfeeding Myths and Legends

Wednesday, June 30th, 2010

Breastfeeding a child until 3 or 4 years of age is abnormal and bad for the child, causing an overdependent relationship between mother and child. Not true! Breastfeeding for 2-4 years was the rule in most cultures since the beginning of human time on this planet. Only in the last 100 years or so has breastfeeding been seen as something to be limited. Children nursed into the third year are not overly dependent. On the contrary, they tend to be very secure and thus more independent. They themselves will make the step to stop breastfeeding (with gentle encouragement from the mother), and thus will be secure in their accomplishment.

A breastfeeding mother cannot get a permanent or dye her hair. Not true! I have no idea where this comes from.

Breastfeeding is blamed for everything.True! Family, health professionals, neighbours, friends and taxi drivers will blame breastfeeding if the mother is tired, nervous, weepy, sick, has pain in her knees, has difficulty sleeping, is always sleepy, feels dizzy, is anemic, has a relapse of her arthritis (migraines, or any chronic problem) complains of hair loss, change of vision, ringing in the ears or itchy skin. Breastfeeding will be blamed as the cause of marriage problems and the other children acting up. Breastfeeding is to blame when the mortgage rates go up and the economy is faltering. And whenever there is something that does not fit the “picture book” life, the mother will be advised by everyone that it will be better if she stops breastfeeding.

(excerpt From Dr. Jack Newman’s breastfeeding myths —  Handout #13. Still More Breastfeeding Myths. Revised January 2005 Written by Jack Newman, MD, FRCPC. © 2005)