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Northern California Babies
Medication and Breastfeeding
I have high blood pressure. It's hereditary. Both of my parents were put on medication for it in their early 20s. The fact that I've made it to my mid 30s without meds is pretty good. My doctor wants to start me on medication to control it. I don't want to take any now because I'm breastfeeding. The medication is listed as "probably safe" to take while breastfeeding.
My doctor gave me a hard time for not wanting to take it. She said the risks to my health are greater than the risks of it getting into my breastmilk. What do you think? Am I being unreasonable? I figured I could start it when I wean which at the most will be 7 months from now (I'll only BF until E is a year).
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Re: Medication and Breastfeeding
I took meds to control my BP while i was nursing without any impact on DS. When it came up I told my PCP I was still nursing with no intent to stop and he STILL Rx'd something that was a big fat no for nursing. I refused to take it. I went home, checked the list in my Nursing Mother's Companion, saw it was ill-advised, saw what they did suggest, and called and asked to switch to the med (propranalol, a beta blocker) that had a long history of use in nursing mother's and was deemed very safe for nursing.
As for your med, did you look it up somewhere (Kellymom.com has a good list) or was it in the paperwork for the medication?
My doctor showed me online the recommendation and it was just deemed Probably Safe. Some medicines that she looked up stated Absolutely Not. None of the medicine she wanted to put me on were listed as just Yes (we looked up other non blood pressure medicine as a comparison and saw that a flat out Yes was an option).
Dang, that sucks! I'm sorry. I'm glad your doc at least attempted other options for you. The only other thing I'll suggest is to go through these forums to see if anyone else has posted about the drug she recommended. https://www.infantrisk.com/forum/forumdisplay.php?12-Antihypertensives
This list of specific drugs is also helpful: https://kellymom.com/health/meds/aap-approved-meds.html#Heart The pregnancy categories aren't totally relevant as secretion in breastmilk is NOT the same as the danger to a fetus in utero.
there is an app i used to have that evaluated meds.. think it was called LatMed? It used the info from Dr. Hale's book. But it sounds like your doc looked into it.
I ended up on quite a few meds while I was BFing and towards the end of my pregnancy. I had a hard time at first going on some of the meds. They have included zoloft, steroids and a number of antibiotics. And I got a lot of mixed feedback from doctors on if BFing was OK while taking diffn't meds. I ended up consulting Ellie's pediatrician, a lactation consultant and my OB for their opinion.
In the end, I decided for all cases, the benefits to me (and in the long term Ellie) outweighed any potential risk to Ellie.
Some things to consider/look into to:
- the metabolism time of the meds. In my case, when I was on steroids, I figured out the time when concs were highest in BM (as discussed in Hale's book). I ended up pumping and dumping one feeding/day. This was mostly because i had to take steroids in am to minimize insomnia... could have not pumped and dumped if I took meds at night.
- (most) meds do not accumulate in BM... like alcohol, there will be a peak in the conc at some point.
Basically, if your doc feels strongly that you should start the meds, and you trust your doc, I would consider doing the meds.
~~ married 8.11.07
~~ DD1 1.16.11 ~~ DD2 1.3.14 ~~
~~ BFP3 12.22.15 MMC 2.29.16 @ 13 weeks ~~
~~ 2 D&Cs (3.1.16 and 3.10.16) for MMC
~~ BFP4 10.27.16 MMC 1.23.17 @ 16 weeks ~~ D&E 1.26.17 ~~
Is there some reason the doctor thinks it is important to start now? Has the BP gone up recently? Did he or she note some complication starting? there may always be some reason to hold off, you may want to have another child, BF again, etc, so it's not just seven months, it could be years before you are done with all that.
It is important to take care of your health so you can be able to enjoy your life as long as possible for your DC. As long as you feel that the doctor has made an effort to pick a medication that seems safe, it's probably best to start it. High bp can really have serious effects as you well know.
I agree with amyfelice. If your doctor thinks it's important to start the BP meds, I would trust him/her.
If you tell me which medication you are meant to start taking, I can look up some more info for you. There is probably not going to be any meds that are 100% safe as there are never any good clinical studies done in the pregnant population.
Cheers,
your friendly pharmacist
I think part of the reason she wants to start now is because it's been high since I had Evan. It was mild hypertension before I had Lucas. But then when I'm pregnant it's low so it's not an issue then. But since I had Evan it's moved into the moderate hypertension category. There are no other complications for starting it now.
We're not having any more children which is why I feel like it's probably OK to hold off until I wean since I will not be getting pregnant again or BF again. I've been watching my salt intake and I've recently started running 3-4 times a week again which I know helps.