Let’s play pretend for a minute. We’re gonna pretend you’re at the doctor’s office being examined for a slightly bothersome issue. Your doctor stops to coo over the adorable baby gnawing his fist in the infant carrier, examines you, and then gives you prescriptions to make your issue go away.
There’s only one hitch: some of it will pass through your breastmilk to your baby, so you may need to stop breastfeeding. What do you do?
This is an all-too-common problem for breastfeeding mothers. The best way to prevent being caught off-guard is to prepare beforehand for your doctor visit. And once you’re in the office, it’s perfectly alright for you to question your doctor about this medicine. In fact, please do! Here are five questions your doctor needs to hear from you before you walk out of the exam room:
Can this wait?
Some problems (like dangerously high blood pressure) must be treated immediately. Other problems (like toenail fungus) can wait. Most issues are going to fall somewhere in that gray area between life-threatening and cosmetic. You and your doctor should analyze your problem from the perspective of risk vs. benefit.
What is the risk of the medication? Is there any risk with postponing treatment?
What is the potential benefit of treatment? Is there any potential benefit of waiting?
There will (and won’t) be times when it makes sense to wait until you’re finished with breastfeeding. Get your doctor’s help in determining how the benefits measure up to the risks.
Is medication really necessary?
Of course, there are times when medicine is needed. We’ve all taken necessary meds at some point. Yet sometimes there are other treatment options.
For instance, anti-anxiety pills can be a godsend (can I get an amen?!). Something else that may be a godsend for you could be a combination of exercise, meditation, deep breathing techniques, and a warm bath.
Is there a relaxation technique, a lifestyle change, or a safe home remedy you could try first? Ask your doctor if there’s a medication-free treatment option.
Are there similar prescriptions that aren’t as risky?
There’s almost always more than one medication for any illness. Choosing a different medication could reduce the risk to your baby.
When my second child was four months old, I started having emotional problems. This wasn’t a temporary bad attitude, this was a long-lasting attitude problem I couldn’t shake. If you just thought about postpartum depression, you’re much quicker than me. I thought postpartum depression was just sadness and that it only happened in the first few weeks after childbirth.
Since I didn’t recognize postpartum depression for what it was, by the time I sought help my depression was severe. When my last baby was born, I started to experience postpartum depression again. This time, I recognized the ugliness for what it was and went to the doctor. We discussed medications, and he prescribed one I was excited about taking – until I learned that it’s not recommended for breastfeeding mothers. We finally were able to find a prescription he was comfortable writing and I was comfortable taking. It worked like a charm – and more important, my baby stayed safe.
The first prescription that comes to your doctor’s mind might not be the best one for a nursing mom. Ask your provider if there are similar drugs that would be safer to use.
Is there a safer way to take this medication?
I probably don’t need to warn you to always start a new drug with the lowest possible dose. You can increase it if needed. There’s no need for 300 mg of a drug if 150 mg would be just as effective. More isn’t always better. Since you already know this, let’s move on to more science-y factors.
Once you take a medicine, there will be a time when it peaks in your system and then begins to wear off. The peak is usually shortly after you take it, but the timing is different for different medications.
The two questions you want to ask are:
- When will it hit peak concentration in my blood? That’s when the largest amount of medicine will be present in your body, and when you most want to avoid breastfeeding.) For many prescriptions it’s about a half hour, just make sure you know the time for your medicine. Try to take it immediately after nursing so it’ll have time to peak and begin to decrease in your body before you need to nurse again.
- What is the half-life of this drug? That means how long it takes for the amount of medicine in your blood to wear off by half. For instance, if there will be 100 mg in your bloodstream within 3o minutes and the half-life is 2 hours, then in 2 hours there will only be 50 mg and in another 2 hours there would only be 25 mg and so on.
It’s a good idea to take your medicine right before your baby’s longest period of sleep. So if your baby usually sleeps 5 hours at night, taking it after his last nursing session of the day should give you about 5 hours before he needs to eat again. That way, your medicine has more time to wear off.
Will this prescription interact with a medicine my baby is taking?
A fact most people don’t consider is that medicine taken by a nursing mom can pass through her milk and interact with medicine taken by her baby. If the pediatrician doesn’t know the mom is on medicine, or if the mother’s doctor doesn’t know the baby is on medicine, it’s incredibly easy for an interaction to happen. Make sure if you and your baby are both taking medicine, that the doctors are aware of all prescriptions.
The wrong combination of drugs could kill your child. Please don’t overlook this question.
Can we get a second opinion?
This is question number six, for when you aren’t satisfied with your doctor’s answers to the previous questions. It’s okay to ask for a second opinion! Not every healthcare professional will take it in stride, but most will be fine with your request. After all, you’re safeguarding the best interests of your baby.
Don’t be shy about asking for a second opinion if you still have concerns!
Medicine can be scary. Just take a few minutes to ask your doctor if immediate treatment is necessary, if alternative therapies are available, and if a similar medicine might be safer. Then learn the safest way to take your prescriptions and make sure they won’t interact with any medicine or supplement your baby may have. Finally, don’t be afraid to ask for a second opinion if you still have doubts.
The health of you and your baby is your biggest concern right now, and you want to know that the treatment plan you choose is the right one. When you ask these questions, you can be confident your new prescription will be safe for your baby!
Do you know of another question you should be asking medical providers? Please share it in the comments below!