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  1. #1
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    Default Is it safe?

    Just woken up with a debilitating migraine and sent DH off to the chemist to buy some Nurofen Plus. Completely forgot to get him to check if this is ok to take while BFing...

    Is it safe??? I just took 2 and bub won't want another feed for about 3-4 hours.

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    It will say on the packet of its not safe to take while BFing.

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    summastarlet  (05-03-2012)

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    Ok so it says not to take while BFing unless under doctors advice....feel like such a bad mummy for not checking before I took it..am just in so much pain I just wanted to make it stop as soon as I could.

    How am I meant to feed bub now???i only have a little amount of EBM in the freezer but it would probably only be enough for 1 feed

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    I don't think it's so dangerous that you won't be able to feed but it's not recommended. I'm not pretending to be an expert though!!

    Definitely phone the ABA or your state's medicine hotline. They will be able to give you up to date information.

    I don't think you'll have to stress about using the EBM, but definitely do some ringing to give you peace of mind!

    Oh and I hope your headache is better

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    summastarlet  (05-03-2012)

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    Quote Originally Posted by Mumtoeli View Post
    I don't think it's so dangerous that you won't be able to feed but it's not recommended. I'm not pretending to be an expert though!!

    Definitely phone the ABA or your state's medicine hotline. They will be able to give you up to date information.

    I don't think you'll have to stress about using the EBM, but definitely do some ringing to give you peace of mind!

    Oh and I hope your headache is better
    Thank you

  8. #6
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    from LactMed

    ibuprofen

    Drug Levels and Effects:


    Summary of Use during
    Lactation:

    Because of its extremely low levels in breastmilk, short
    half-life and use in infants in doses much higher than those excreted in
    breastmilk, ibuprofen is a preferred
    choice as an analgesic or antiinflammatory agent in nursing
    mothers.


    Drug Levels:
    Maternal Levels.
    Two early studies attempted measurement of ibuprofen in milk. In one, the patient's dose
    was 400 mg twice daily, while in the second study of 12 patients, the dose was
    400 mg every 6 hours. Ibuprofen was
    undetectable in breastmilk in both studies (<0.5 and 1 mg/L,
    respectively).[1][2]

    A later study using a more sensitive assay found
    ibuprofen in the breastmilk of one woman
    who took 6 doses of 400 mg orally over a 42.5 hours. A milk ibuprofen level of 13 mcg/L was detected 30
    minutes after the first dose. The highest level measured was 180 mcg/L about 4
    hours after the third dose, 20.5 hours after the first dose. The authors
    estimated that the infant would receive about 17 mcg/kg daily (100 mcg daily)
    with the maternal dose of approximately 1.2 grams daily. This dose represents
    0.0008% of the maternal weight-adjusted dosage[3] and 0.06% of the commonly
    accepted infant dose of 30 mg/kg daily (10 mg/kg every 8
    hours).

    Infant Levels. Relevant published information was not
    found as of the revision date.


    Effects in Breastfed
    Infants:

    At least 23 cases are reported in the literature in which
    infants (ages not stated) were breastfed during maternal ibuprofen use with no adverse effects
    reported.[1][3][4]


    Possible Effects on Lactation:

    Relevant published information was not found as of the revision
    date.


    Alternate Drugs to Consider:
    Acetaminophen,
    Flurbiprofen,
    Indomethacin,
    Naproxen, Piroxicam
    Last edited by BH-tech; 16-12-2014 at 15:47. Reason: Link Removal

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    summastarlet  (05-03-2012)

  10. #7
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    from LACTMED

    codeine
    Drug Levels and Effects:


    Summary of Use during
    Lactation:

    Maternal use of oral narcotics while breastfeeding can
    cause infant drowsiness in a dose-dependent fashion, with pharmacogenetics
    possibly playing a role.[1][2] Newborn infants seem to be particularly sensitive
    to the effects of even small dosages of narcotic analgesics, particularly in the
    first week of life. However, the newborn's dosage is limited by the small
    volumes of colostrum in the first 2 to 3 days postpartum. Once the mother's milk
    comes in, it is best to use a nonnarcotic analgesic and limit the maternal
    dosage and duration of treatment with codeine (and combinations) to 4 days.[2][3][4]
    Monitor the infant for drowsiness, adequate weight gain, and developmental
    milestones, especially in younger, exclusively breastfed infants. If the baby
    shows signs of increased sleepiness (more than usual), difficulty breastfeeding,
    breathing difficulties, or limpness, a physician should be contacted
    immediately.[5]




    Effects in Breastfed Infants:

    Codeine was reported to be the possible cause
    of asymptomatic bradycardia 6 days following a 30 mg single maternal codeine dose in a week-old, term, exclusively
    breastfed infant.[12]

    Four probable cases of apnea associated with
    maternal codeine intake of 60 mg every 4
    to 6 hours were reported in 4- to 6-day-old term and near-term breastfed
    infants. Apnea resolved 24 to 48 hours after withholding breast feeding and
    discontinuation of maternal codeine.[13]

    In a case-control study of
    12 breastfed term newborns with unexplained episodes of apnea, bradycardia or
    cyanosis during the first week of life, maternal oral codeine use was determined to be the probable
    cause. A higher proportion of newborns with episodes, 83 vs 31%, had mothers
    using opiates, including codeine, for
    postpartum analgesia. The mean number of doses taken was also higher with
    mothers of case newborns taking a mean of 10 doses (range 4 to 22) vs. 5 doses
    (range 1 to 13) in the control group. There were no differences in other
    perinatal and demographic factors between cases and controls.[14] The authors
    recommended discontinuation of breastfeeding if infants of mothers taking opiate
    analgesics have unexplained negative cardiorespiratory symptoms.

    No
    apnea, bradycardia, or color changes occurred in 11 healthy, term, 1- to
    3-day-old newborn breastfed infants exposed to codeine in milk. Their mothers had taken an
    average of 4 doses of oral codeine 60 mg
    every 4 to 6 hours prior to breastfeeding.[9]

    In one telephone follow-up
    study, 19% (5 of 26) of breastfeeding mothers taking multiple doses of codeine reported drowsiness in their infants.
    All infants were younger than 1 month.[15] The authors added that the
    elimination half-life of codeine's
    metabolite, morphine, is prolonged in the newborn period which may explain why
    the adverse reaction was reported in only infants younger than 1 month.

    A
    large case-control study of 504 children with neuroblastoma found a
    statistically significant 2.4-fold association of the disease with maternal use
    of opioid agonists during pregnancy and lactation. This finding was largely
    attributable to a 3.4-fold association with maternal codeine use. Opioid exposure during lactation
    had a 3.5-fold association while codeine
    exposure had a 5.1-fold association. Because neuroblastoma is a sympathetic
    nervous system tumor arising from the progenitor cells of the sympathetic
    ganglia and adrenal medulla, and because codeine does cross the placenta and is
    transferred to milk, the authors of this study speculate that codeine's neuroendocrine effects could disrupt
    adrenal gland development in the fetus and neonate thus contributing to
    neuroblastoma.[16]

    A breastfed infant became increasingly sleepy and
    lethargic starting on day 7 of life. The infant developed gray skin and
    decreased milk intake on day 12 of life and died on day 13 of life. The infant's
    mother was taking acetaminophen with codeine prescribed for post-episiotomy pain at
    a codeine dose of 60 mg every 12 hours
    on days 1 and 2 postpartum, and 30 mg every 12 hours for 2 weeks. The mother was
    found to be a ultrarapid metabolizer of codeine who excreted very large amounts of
    morphine into her breastmilk.[10] The authors later conducted a retrospective
    case-control study of 72 women who had taken codeine while breastfeeding found that 24% of
    the mothers reported decreased alertness in their infants which improved after
    codeine or breastfeeding
    discontinuation. The affected infants were more likely to have visited an
    emergency room for symptoms such as lethargy, poor feeding or breathing
    difficulties. Mothers with affected infants took an average of 1.62 mg/kg daily
    or codeine compared to an average of
    1.02 mg/kg daily in mothers of unaffected infants. The lowest maternal dose
    reported cause symptoms in the breastfed infant was 0.63 mg/kg daily. Usually
    the mothers of affected infants also had signs of central nervous system
    depression. Another woman was also an ultrarapid codeine metabolizer in addition to the first
    case reported. She took 120 mg of codeine daily and her infant was very drowsy
    and fed poorly and the mother was sedated, nauseated, dizzy, and weak during
    codeine use. The mother transitioned to
    complete formula feeding by day 7 postpartum and noted a complete reversal of
    her infant's symptoms although she remained symptomatic.[17]

    A study
    compared the frequency of drowsiness in breastfed infants whose mothers took
    acetaminophen plus codeine to infants
    whose mothers took acetaminophen alone. Infants exposed to codeine had a 16.7% frequency of drowsiness
    compared to 0.5% of those exposed to acetaminophen alone. Mothers having infants
    with drowsiness took about 50% higher doses of codeine than those with no
    drowsiness.[18]

    In a retrospective study, nursing mothers who were taking
    either codeine, oxycodone or
    acetaminophen for pain while breastfeeding were contacted by telephone to
    ascertain the degree of maternally perceived central nervous system (CNS)
    depression. Some of the mothers taking codeine had been previously reported in
    reference [17]. Mothers taking codeine
    reported signs of CNS depression in 17% (35/210) of their infants, while those
    taking acetaminophen reported infant CNS depression in only 0.5% (1/184) of
    their infants. Women who reported infant sedation were taking 1.4 mg/kg daily of
    oxycodone, and unaffected were taking 0.9 mg/kg daily. Affected infants had more
    hours of daily uninterrupted sleep than unaffected infants, and 4 of the
    affected infants had been taken to the emergency department for lethargy. Thirty
    of 35 mothers reported that infant sedation ceased with maternal codeine discontinuation. Mothers of affected
    infants were also more likely to experience lethargy and other side effects than
    mothers of unaffected infants. Mothers who took oxycodone reported a similar
    rate of infant sedation (20%) compared to codeine, but the groups were statistically
    different in parity and postmenstrual age (PMA), with the codeine group having a slightly higher
    PMA.[19]


    Possible Effects on Lactation:

    Narcotics can increase serum prolactin.[20] However, the prolactin level in
    a mother with established lactation may not affect her ability to
    breastfeed.


    Alternate Drugs to Consider:
    Acetaminophen,
    Ibuprofen, Morphine
    Last edited by BH-tech; 16-12-2014 at 15:48. Reason: Link Removal

  11. The Following User Says Thank You to Bubbles10 For This Useful Post:

    summastarlet  (05-03-2012)

  12. #8
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    ABA 1800 mum 2 mum (1800 686 268)




    https://www.breastfeeding.asn.au/bf-info/safe-when-breastfeeding/breastfeeding-and-prescription-medications




    Breastfeeding and prescription medications





    Prescription medications and breastfeeding



    Breastfeeding mothers can safely use most prescribed medications.

    Natural barriers in the cells that create breastmilk make it difficult for most medications to pass into your milk. Even for those medications that do enter breastmilk, most do so in amounts so low that there is no effect on the baby.

    Before your doctor prescribes a medication for you, make sure he or she knows that you are breastfeeding. If your doctor is unsure whether or not you can breastfeed safely while taking a particular medication, ask that they check with drug information experts.

    For current information about the use of medicines/drugs during breastfeeding (or pregnancy), contact the Medicines Information Centres in your state or the
    NPS Medicines Line. The numbers are listed below.

    Most centres operate during normal business hours. If a call is urgent and outside these hours, ring the Poisons Information Centre on 13 11 26 (all states & territories).


    Mothers Location
    Service
    Telephone (BH)
    ACT
    Medicines Information Centre

    Canberra Hospital
    02 6244 333
    NSW
    MotherSafe, Royal Hospital for Women

    Randwick
    02 9382 6539

    1800 647 848

    (NSW country)
    QLD
    NPS Medicines Line
    1300 633 424
    SA
    Medicines Information Centre

    Women’s and Children’s Hospital
    08 8161 7222
    TAS
    Medicines Information Centre

    Royal Hobart Hospital (Mon-Thu)

    NPS Medicines Line (Fri)
    03 6222 8737



    1300 633 424
    VIC
    Medicines Information Centre

    Monash Medical Centre
    03 8345 3190
    WA
    Women & Newborn Health Services (KEMH)
    08 9340 2723
    All states & territories
    NPS Medicines Line (9 am-5 pm AEST) 1300 633 424


    Poisons Information is available 24 hours a day 7 days a week on 13 11 26 (all states & territories)



  13. The Following User Says Thank You to Bubbles10 For This Useful Post:

    summastarlet  (05-03-2012)

  14. #9
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    Thanks Bubbles. Ended up finding the Medicine Line number in my ABA book and called to put my mind at ease.


 

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