By Stephanie Sublett MD, IBCLC Ob/Gyn & Breastfeeding Medicine Specialist
Breastfeeding provides numerous benefits for both the mother and the infant. However, there may be times during lactation when medication is necessary, and parents may be concerned about the safety of continuing breastfeeding while on medication. Pumping and dumping, while commonly suggested as a way to manage the situation, may not always be necessary. In this blog post, we will explore the reasons why most parents do not need to pump and dump while on medication and the risks associated with pumping and dumping.
Pumping and dumping is not necessary unless there is a legitimate concern about medication exposure to the infant. Parents can continue breastfeeding while taking medication, as the levels of medication in breast milk are often very low. Additionally, pumping and dumping can place unnecessary stress on parents who are already adjusting to the changes of postpartum life. Parents who are exclusively breastfeeding may be unfamiliar with pumping, which can cause further anxiety, stress, and confusion.
Moreover, when considering the risks of pumping and dumping, it is essential to note that the contents of breast milk change based on the time and frequency of breastfeeding. If a parent stops breastfeeding and pumps instead, the milk composition will change, which can affect the infant's growth and development. The routine of nursing may also be disrupted, leading to engorgement, infection, and an overall decrease in milk supply.
Additionally, pumping and dumping may not be the safest option for infants in situations where medication exposure is a real concern. It is possible to save pumped milk for when the infant is older or mix it with other expressed milk to dilute the medication's effects. Research evidence indicates that some medications are relatively safe for breastfeeding infants. In these cases, it is not necessary to pump and dump or to prematurely wean the breastfeeding infant. Overall, pumping and dumping carries more risks than benefits when it comes to managing medication during breastfeeding.
Here are a list of common scenarios where breastfeeding is safe and does not need to be interrupted¹:
Surgery
Anesthesia
MRI and CT scan with contrast, x-ray’s, mammograms
Breast biopsy with titanium clip placement
Breast masses and nipple discharge
Injectable numbing medication
Teeth whitening
Caffeine
Reasonable amounts of alcohol
Acupuncture
Dental procedures
Nyquil and other over-the-counter cold medications
Airport security scans
Skin peels
Botox
Fillers
Laser procedures
Tanning beds
Spray tans
Hair dyes or other hair treatments
Tattoos
Anti-depressants and anti-anxiety medication
Blood pressure medication
Acne medication
Animal bites on the breast
Breastfeeding is safe with fish consumption.
Furthermore, pharmacologic principles dictate the safety of medications while breastfeeding. Lactational pharmacology is a specialized field that examines the properties of the medication, its effects on milk production and secretion, and the absorption of the medication by the infant. Healthcare practitioners, including lactation consultants, can provide evidence-based information about medication safety during breastfeeding. With shared decision making, parents can understand the risks and benefits of medication exposure to the infant, along with alternatives to pumping and dumping.
Trusted resources for moms to check safety of medications during lactation:
LactMed Database: A comprehensive, up-to-date database providing information on the safety of medications during breastfeeding.
MotherToBaby: A service of the Organization of Teratology Information Specialists, offering evidence-based information on medications and other exposures during pregnancy and breastfeeding.
InfantRisk Center: Part of Texas Tech University Health Sciences Center, providing the latest research on medication safety during pregnancy and breastfeeding.
American Academy of Pediatrics (AAP): Offers guidelines and resources related to breastfeeding and medication use.
TrashThePumpAndDump.org: An advocacy organization dedicated to debunking myths about medication and breastfeeding. They aim to provide accurate, credible information and encourage open conversations between mothers and healthcare providers about safe medication use during lactation.
InfantRisk App: An app developed by the InfantRisk Center, offering the latest research on medication safety during pregnancy and breastfeeding.
MommyMeds App: A user-friendly app providing up-to-date, evidence-based information on medication safety during pregnancy and breastfeeding.
LactRx App: This app offers a comprehensive database on medications and their safety profiles during lactation. It's a great resource for breastfeeding mothers needing detailed information about medication use.
HalesMeds App: Named after Dr. Thomas Hale, a renowned expert in perinatal pharmacology, this app provides detailed information on various medications and their compatibility with breastfeeding.
Breastfeeding parents should not be fearful or discouraged from taking medication while breastfeeding. Pumping and dumping is not the only option for managing medication exposure, as most medications are relatively safe for breastfeeding infants. Shared decision making with healthcare practitioners is essential to ensure the safest and most effective way to manage medication during lactation. Parents can continue to enjoy the benefits of breastfeeding while being confident that their infant is safe and protected.
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