A modern lifestyle brand redefining motherhood
Print Friendly and PDF

Breastfeeding mothers may have a number of reasons they are considering taking medication. They may have pain resulting from birth, postpartum depression, or of course be dealing with health conditions completely unrelated to their pregnancies or labors.

In all of these cases, women who have just given birth may find it difficult to treat these issues because their medications are considered unsafe for breastfeeding infants. It can also be really difficult to figure out which medications are safe, and which should be avoided. So, let's dive into the science behind it.

What medications are safe to take while breastfeeding?

The American Academy of Pediatrics (AAP) opened its 2013 statement on The Transfer of Drugs and Therapeutics into Human Milk with an explanation for why physicians might tell lactating women not to breastfeed while on certain medications.

FEATURED VIDEO

First, there may just not be any evidence—positive or negative—about the effects of a particular drug on human milk. It is often difficult to run ethical studies if there is any concern about the potential harm of a drug to an infant. Interestingly, the drug studies that physicians do base their breastfeeding recommendations on often come from animal studies, which only imperfectly apply to humans.

The AAP asserts that physicians should consider a host of factors when prescribing medications to lactating women, which include: “the need for the drug by the mother, the potential effects of the drug on milk production, the amount of the drug excreted into human milk, the extent of oral absorption by the breastfeeding infant, and potential adverse effects on the breastfeeding infant."

Given all of the factors to consider when prescribing a medication, it's no wonder there can be disagreement on whether any particular medication is safe, or why a woman's provider advises her to stop or continue breastfeeding.

When looking for drug information, new mothers might question whether a drug is safe or unsafe for breastfeeding—unfortunately answers are often not cut and dry. Given the vast array of medications available and each individual provider's experience, the “safe or unsafe" question might be answered differently by different people.

When making the choice to take a medication and pause or discontinue breastfeeding, nursing mothers might do well to think less in terms of absolutes and more in terms of concentration, in collaboration with their provider, of course.

Consider the concentration of a drug

The first way to think about medication and breastfeeding is in terms of dosage. Consider a drug many people don't even think of as a drug: Caffeine. Drink 0.1 grams (the amount of caffeine in one cup of coffee), and you'll find it easier to make it through your day after three middle-of-the-night wake-ups. Ingest 30 grams, as two students recently did when they were accidentally overdosed during a research study, and if you're lucky, you'll end up in intensive care.

In the case of nursing mothers, dosing is especially complicated. The prescribing physician has to consider not just the right dose for the mother, but also a safe dose for the child who may receive some of that drug through the mother's breast milk.

To make calculations about how much of any particular drug will be present in breast milk, the physician must consider how that drug travels to different parts of the body. In pharmacology, this is called distribution. Some medications are water-soluble, meaning that they dissolve in water, while other medications are fat-soluble.

The solubility of a drug determines how that drug will be distributed throughout the body. Alcohol, for example, is water-soluble. Furthermore, it dissolves quickly in water, which is why it moves so rapidly from the intestines to the bloodstream, and from the bloodstream throughout the body. Alcohol's solubility is part of the reason it is found only in trace amounts in breast milk and generally regarded as safe to drink while breastfeeding.

Is over the counter pain medication safe while breastfeeding?

Many classes of pain medications are also water-soluble. Women who have had C-sections are often given morphine, also a water-soluble drug, because it appears only in trace amounts in breast milk.

The commonly used acetaminophen and ibuprofen are generally considered safe.

Medications are said to be “lipophilic" when they have a tendency to concentrate in fat. Because breast milk contains a high proportion of fat, it will also contain a high proportion of a drug that dissolves in fat. Therefore, fat-soluble medications are often prescribed with caution.

Is anxiety medication safe while breastfeeding?

SSRIs, which are prescribed for anxiety and depression, are lipophilic and have relatively long half-lives, meaning that they both dissolve in fat and take longer to metabolize. Although the infant exposure to SSRIs through breast milk is still relatively low, there have not been long-term studies of this exposure, so women who need these drugs may be discouraged from breastfeeding.

The solubility of a medication is just one of a host of factors physicians need to consider when making a recommendation about breastfeeding while on that medication. New drugs are introduced all the time, and drugs that were previously thought to be safe for mothers to take while breastfeeding are sometimes found to be unsafe (codeine is one such example).

LactMed, a database maintained by the U.S. National Library of Medicine, is regularly updated with new drug information and can be used to help evaluate whether a particular medication is safe for a nursing infant.

Concentration of the parent

The concentration of a particular drug is important because of the amounts that may appear in breast milk. If that amount is deemed too high, a woman might be counseled to stop breastfeeding, or at least to change the dosage of the drug. According to the American Academy of Pediatrics, remarkably few medications absolutely require breastfeeding cessation.

But the concentration of a drug in the mother's milk is only one way to think about concentration. It's also important for prescribing physicians to consider “concentration" as a mental state. Narcotics like morphine can interfere with awareness, so even if they won't pass into the bloodstream, they may temporarily incapacitate the mother.

While that mother's milk may be completely safe for the infant, that mother's diminished concentration may make it less safe for her to be holding—and therefore nursing—the baby.

A more conservative approach might be to feed a baby expressed milk or formula until the medication wears off.

In other cases, physicians might be weighing the mother's ability to safely care for her baby against her ability to nurse that baby. This is often the consideration when prescribing antidepressants which may require cessation of breastfeeding.

Concentration of the provider

In weighing potentially competing recommendations about whether or not to stop nursing while on medication, it's also worth focusing on the physician's concentration. The safety of the infant is obviously of concern to any provider prescribing a medication to a nursing mother. But it's important to note that, in cases where medication is deemed medically necessary for a lactating mother, the mother—not the baby—is the patient.

Although women should feel comfortable asking questions about alternative medications that may make it easier to continue breastfeeding, it's worth noting that at a time when everything now appears to revolve around the baby, the mother's provider will focus on the mother. Because of this, a physician may make recommendations about the mother's health that may be momentarily at odds with her plans to breastfeed.

So, can I take medication while breastfeeding?

When weighing the decision to take a medication and pause or stop breastfeeding, nursing mothers should consider all three of the above forms of concentration. They can ask their providers about the dosage and its possible effects on breast milk. They can ask how a medication deemed safe for breastfeeding might impact their own mental state. And they can ask for advice in weighing the health impacts of the medication against the drawbacks of pausing or stopping breastfeeding.

There are rare times when the best decision may be to pause breastfeeding or stop breastfeeding altogether. At those times, it's important to consider one last form of concentration. Infant formula is also a “concentration," a combination of proteins, fats, and carbohydrates.

The decision to use formula while on a potent medication can feel like a failure to many mothers, who are flooded with messages about the importance of breastfeeding. But if short-term formula use can ensure a long-term benefit for the mother, that mother can be a healthy parent to her baby for life.

You might also like:

The very best of Motherly — delivered when you need it most.

Subscribe for inspiration, empowering articles and expert tips to rock your best #momlife.

Already a subscriber? Log in here.

Pop quiz, mama! How many different types of car seats are there? If you guessed three, you're partially correct. The three main types are rear-facing car seats, forward-facing car seats, and booster seats. But then there are a variety of styles as well: infant car seats, convertible seats, all-in-one seats, high-back booster seats, and backless boosters. If you're not totally overwhelmed yet, keep reading, we promise there's good stuff ahead.

There's no arguing that, in the scheme of your baby and child gear buying lifetime, purchasing a car seat is a big deal! Luckily, Walmart.com has everything you need to travel safely with your most precious cargo in the backseat. And right now, you can save big on top-rated car seats and boosters during Best of Baby Month, happening now through September 30 at Walmart.com.

As if that wasn't enough, Walmart will even take the carseat your kiddos have outgrown off your hands for you (and hook you up with a sweet perk, too). Between September 16 and 30, Walmart is partnering with TerraCycle to recycle used car seats. When you bring in an expired car seat or one your child no longer fits into to a participating Walmart store during the trade-in event, you'll receive a $30 gift card to spend on your little one in person or online. Put the money towards a brand new car seat or booster or other baby essentials on your list. To find a participating store check here: www.walmart.com/aboutbestofbabymonth

Ready to shop, mama? Here are the 9 best car seat deals happening this month.


Safety 1st Grow and Go Spring 3-in-1 Convertible Car Seat

walmart-best-baby-carseat

From rear-facing car seat to belt-positioning booster, Grow and Go Sprint's got you covered through childhood. Whether you choose the grey Silver Lake, Seafarer or pink Camelia color palette, you'll love how this model grows with your little one — not to mention how easy it is to clean. The machine-washable seat pad can be removed without fussing with the harness, and the dual cup holders for snacks and drinks can go straight into the dishwasher.

Price: $134 (regularly $149)

SHOP

Baby Trend Hybrid Plus 3-in-1 Booster Car Seat in Bermuda

walmart-best-baby-carseat

When your toddler is ready to face forward, this versatile car seat can be used as a five-point harness booster, a high-back booster, and a backless booster. Padded armrests, harness straps, and seat cushions provide a comfy ride, and the neutral gray seat pads reverse to turquoise for a stylish new look.

Price: $72.00 (regularly $81)

SHOP

Baby Trend Hybrid Plus 3-in-1 Booster Car Seat in Olivia

walmart-best-baby-carseat

Looking for something snazzy, mama? This black and hot pink car seat features a playful heart print on its reversible seat pad and soft harness straps. Best of all, with its 100-pound weight limit and three booster configurations, your big kid will get years of use out of this fashionable design.

Price: $72.00 (regularly $81)

SHOP

Evenflo Triumph LX Convertible Car Seat

walmart-best-baby-carseat

This rear- and forward-facing car seat keeps kids safer, longer with an adjustable five-point harness that can accommodate children up to 65 lbs. To tighten the harness, simply twist the conveniently placed side knobs; the Infinite Slide Harness ensures an accurate fit every time. As for style, we're big fans of the cozy quilted design, which comes in two colorways: grey and magenta or grey and turquoise.

Price: $116 (regularly $149.99)

SHOP

Disney Baby Light 'n Comfy 22 Luxe Infant Car Seat

walmart-best-baby-carseat

Outfitted with an adorable pink-and-white polka dot Minnie Mouse infant insert, even the tiniest of travelers — as small as four pounds! — can journey comfortably and safely. This rear-facing design is lightweight, too; weighing less than 15 lbs, you can easily carry it in the crook of your arm when your hands are full (because chances are they will be).

Price: $67.49 (regularly $89.99)

SHOP

Graco 4Ever 4-in-1 Convertible Car Seat

walmart-best-baby-carseat

We know it's hard to imagine your tiny newborn will ever hit 100 lbs, but one day it'll happen. And when it does, you'll appreciate not having to buy a new car seat if you start with this 4-in-1 design! Designed to fit kids up to 120 lbs, it transforms four ways, from a rear-facing car seat to a backless belt-positioning booster. With a 6-position recline and a one-hand adjust system for the harness and headrest, you can easily find the perfect fit for your growing child.

Price: $199.99 (regularly $269.99)

SHOP

Graco SlimFit All-in-One Convertible Car Seat

walmart-best-baby-carseat

With its unique space-saving design, this 3-in-1 car seat provides 10% more back seat space simply by rotating the dual cup holders. The InRight LATCH system makes installation quick and easy, and whether you're using it as a rear-facing car seat, a forward-facing car seat, or a belt-positioning booster, you can feel confident that your child's safe and comfortable thanks to Graco's Simply Safe Adjust Harness System.

Price: $149.99 (regularly $229.99)

SHOP

Graco Snugride Snuglock 35 Platinum XT Infant Car Seat

walmart-best-baby-carseat

Making sure your infant car seat is secure can be tricky, but Graco makes it easy with its one-second LATCH attachment and hassle-free three-step installation using SnugLock technology. In addition to its safety features, what we really love about this rear-facing seat are all of the conveniences, including the ability to create a complete travel system with Click Connect Strollers and a Silent Shade Canopy that expands without waking up your sleeping passenger.

Price: $169.99 (regularly $249.99)

SHOP

Graco Snugride Snuglock 35 Elite Infant Car Seat

walmart-best-baby-carseat

With just one click, you can know whether this rear-facing car seat has been installed properly. Then adjust the base four different ways and use the bubble level indicator to find the proper position. When you're out and about, the rotating canopy with window panel will keep baby protected from the sun while allowing you to keep your eye on him.

Price: $129.99 (regularly $219.99)

SHOP

This article was sponsored by Walmart. Thank you for supporting the brands that support Motherly and mamas.

Our Partners

Kid's birthday parties can be great: There's lots of playtime for little ones to wear themselves out, the entertainment is free and it's the perfect time to bond with other mamas. But when it comes to gift-giving, everyone's interpretation of these unwritten rules is different which can create unwanted stress.

You know the scene: Some mamas prefer to give handmade gifts, others like buying popular toys and some only contribute to the child's college tuition.

If you haven't already heard, the trending theme for kid's birthday parties is "the fiver" and it takes the guesswork out of gift-giving. Rather than spending $20 on a toy they probably won't play with in a month the hosts ask for a $5 bill. The money is pooled together and can be put towards one big, much more significant gift, instead of many smaller, less meaningful things. The idea is simple, and it turns out, hosting one is similar to throwing a traditional birthday party.

FEATURED VIDEO

Here are six ways to throw a seamless (and fun!) fiver party:

1. Don't do it alone

Many moms tend to plan everything for their kids' parties all by themselves. They write down a list of things that they need to do and feel accomplished after checking off every single item. But, when the special day finally comes, moms stress over the details for fear that something might go wrong.

When planning a fiver party, delegate tasks and responsibilities during the planning process. Having a helper or two for the big day cuts down on having to clean up a big mess afterward.

2. Create a distraction-free environment

Though this sounds like a tip for doing homework, it applies to throwing a party, too. If you book a show for 3- or 4-year-olds, it's better to hide all the toys and snacks beforehand so they can sit longer and focus better on the activity you planned. Best of all, with fiver parties, you don't have to worry about designating an area to open a bunch of gifts.

3. Remember that hand painting is better for toddlers

Many children like to get their faces painted for their birthdays or for special events. Though face painting is a popular activity, children who are less than 4 years old will often start moving, fidgeting or crying in the middle of it and turn the beautiful butterfly on their faces into a mess. Because of this, try hand painting for the younger ones.

4. Always keep them busy

Fill your fiver party with activities so that the guests will always have something to do. Maybe this sounds a bit difficult, but you don't necessarily need to book 10 shows for one party. Simply prepare a few easy games (like a treasure hunt, musical chairs and sack race) for them to play beforehand. Keeping the children occupied will make your fiver party fun and memorable.

5. Less is more

A shortlist of guests will keep your little one from feeling overwhelmed by the attention. For toddlers, a party that lasts about an hour and a half is perfect. If they're a bit older, add another hour. Just remember children don't need much to feel happy and loved.

Bonus! Here are two ways to save money while making your kids' fiver party memorable:

1. Host the party at home.

Sure, venues are great, but they can be pricey. Having a party at home is inexpensive and intimate. Also, kids are more likely to interact with each other if the space is smaller.

2. Only serve snacks.

A common way to stay on budget is to invite people between meals and prepare snacks, not a full meal. Most kids are usually so busy playing they'll just graze anyway.

This article was originally published on Partify by Natalie Wong and it has been republished with permission from the author.

You might also like:


Learn + Play

When your toddler is screaming for milk, a toy or a snack in the middle of the grocery store, it may feel like your world is closing in on you. It might not seem like it in the moment, but tantrums are a normal part of your child's development—it's a child's way of expressing how they feel.

But regardless of why little ones throw fits, it can be tough to navigate. We looked to the parenting threads on Reddit where mamas discuss the ins and outs as well as ups and downs of child-rearing. We were all ears.

Here's the best tantrum advice Reddit mamas swear by:

1. Wait it out

"Tantrums are a toddler's way of venting excess frustration, energy and emotion. Just wait it out and once it's dying down, offer some comfort. After, talk with them and verbalize and validate their emotions."— StayAtHome478936

FEATURED VIDEO

2. Don't entertain it

"Do not engage with them at all during a tantrum. It's tempting to try to calm them down and introduce some reason to the situation, but don't give in to that. Screaming is a one-way ticket to being completely ignored. They're allowed to be frustrated and upset, but you're not obligated to listen to it."— VoteyDisciple

3. Give yourself a mommy break

"I give myself mommy time outs if I'm getting frustrated or angry and even though no one is enforcing me, I still get the benefit of calming myself down, and my daughter sees me proactively taking care of my mood/behavior."— ChandrikaMoon

4. Let them explore their world

"If you have patience with misbehavior, you open the door to your child escalating until she has your full attention. I let my toddler explore her world and do anything I deem safe, but I am strict about enforcing safety rules and I do not allow her to misbehave without consequences."— soMuchToFind

5. Focus on the real issue

"Rather than punishing the symptom of the issue, work on the actual issue. For my 4-year-old son we are working on breathing and counting as a coping mechanism for when emotions become too overwhelming. For him, it works well. He responds to most minor and medium emotions by breathing now."— Hiitskai

6. Say 'no' less

"There is a school of thought that if the child reacts terribly every time you say 'no,' say 'no' less. Instead of no cookie you say you can have carrots or cheese now. Always offer one or two good choices when you can and it will head off at least some of the fits."— toasterchild

7. Take away things

"My kid started showing signs of being low-level obsessed with a game so we took it away cold turkey. We explained that the game makes him behave in a way we don't like, so we are going to take a break. Sure he wasn't happy about it, but we are the adults and he is entitled to feel any way he wants to."— greenpotatoes9

8. Offer breaks

"Daycare helped us so much with tantrums. They taught her the phrase 'I need my space.' So, when she has her tantrum, she goes away for a moment, and then comes back in a calmer state of mind. Often, the more we try to help her, the worse it gets."— dave moe dee

9. Play music

"The main thing that almost never fails is listening to music during a tantrum. I'm really into music myself so I guess this is no huge surprise but my girl just cannot cry while Beyonce is playing."— PavLovesDogs

10. Do something unrelated

"As long as the kid isn't actively endangering themselves while throwing the temper tantrum, I completely ignore it. I make a point of going about my business and doing something wholly unrelated to whatever lead up to the tantrum. It didn't take long for my kid to learn that the screaming and fussing won't get them what they want."— PerestroikaPal

11. Compromise

"If you give into a tantrum, find a way to make it seem like you're compromising for some other reason, but not because of the tantrum. I always tell my 3 year old 'You know how to ask. If you want something, use your words, ask nicely."—athaliah

You might also like:

Learn + Play

When kids enter puberty we warn them about the change. We tell them their bodies are changing and that it's normal and natural and they're beautiful just as they are. But when women become mothers and their bodies—and brains—change, we are not offered the same affirmations and comfort as adolescents. Society tells children to accept the ways their bodies stretch, grow and shift to carry them through adulthood, but it tells the women who carry these children in their own bodies to fight change at all costs.

Luckily, that is changing. Women are standing up and saying what society should have been telling us all along: Yes, motherhood changes your body, but that change is beautiful.

And now, in a brilliant move that is both excellent marketing and empowering, hundreds of women are putting their postpartum bodies on display. The act is a powerful statement to themselves and to other mothers: Our bodies are meant to evolve and change, and you are normal and natural and beautiful just as you are.

Knix is selling underwear, but the brand is also creating real change with a project called The Life After Birth Project, which saw 250 photos of real moms exhibited in an NYC gallery before rolling into Knix's hometown, Toronto, Canada, this week.

The photos are refreshingly real and exactly what women need to see in 2019.

The Life After Birth Project shows the beauty and reality of postpartum healing 

One of the most damaging myths about postpartum recovery is that it is quick. It isn't. It actually takes about six to eight weeks for the uterus to shrink back to its pre-pregnancy size. The bump doesn't instantly disappear because it took 9 months to grow. A mother's body needs time to heal after birth, whether it was a vaginal delivery or a C-section, but too many mothers aren't given that time.

In the United States, so many working moms are back at their job within five weeks of giving birth, and even if paid work isn't a factor, unpaid labor and family obligations can have mothers doing too much too soon.

As Diana Spalding, midwife and Motherly's Digital Education Editor and Birth Expert, has said, "You would never expect someone to clean their house a few days after having surgery, or to run errands when they are getting over the flu—so why do we expect ourselves to snap out of giving birth? Pregnancy and birth are not ailments, but they are the real deal. Be gentle on yourself, and allow your body to heal."

Mothers should not be embarrassed by their changing bodies 

A recent survey found more than a third of women (37%) felt embarrassed by what their body was going through after birth. This is not okay, and it is why we need more projects like the The Life After Birth Project and more companies doing what Knix is doing.

That is why celebrities like Jillian Harris, pictured above, stepped up and shared photos of their own postpartum experiences for the Life After Birth project.

Yes, Jillian is wearing mesh panties and a giant pad in the above photo. But that's part of the journey and nothing to be embarrassed about.

We need to see our stories represented and know that this is normal.

More photos from #LifeAfterBirth

Four pregnancies in four years. This mama has been through so much and has some serious advice: "I wish our always busy culture recognized it more and gave new mothers patience and grace."

So do we Amy, so do we.

See the gallery in person

The Life After Birth Project is currently in Toronto but the next stop is Los Angeles on October 24.

The gallery will keep touring the US, too.

Stops are planned in Portland, Seattle, Dallas, Austin, Denver, Minneapolis. if you want to submit your own photos, tag @lifeafterbirthproject on Instagram and use the hashtag #LifeAfterBirth, or email your photos to lifeafterbirth@knix.com.

You might also like:


News

You know that moment when you find yourself standing in line at the grocery store next to the "All-Together Woman"? Come on, you know the one.

She very well may have just stepped out of a magazine centerfold, while you are fairly certain you resemble something more along the lines of a real-life muppet. This woman is flawless. Her makeup is spot-on, her clothes are wrinkle-free. Her toes are manicured and her fingernails look like they never once, in the course of her what-must-be-a-dream-life, scrubbed a single dirty bathtub, poopy toilet or messy kitchen floor.

Okay, seriously, I know you know what I am talking about now.

FEATURED VIDEO

But, here's the thing. I don't hate her. I don't even envy her. Because I don't know her. I have no idea what her personal struggles are. I applaud her for her obvious fashion skills and mad makeup abilities. I will probably even tell her I love her hair. Or her shoes. Or her something.

And, for all I know, while I am admiring her trendy jacket and cropped top she very well may be admiring my children and my life. Maybe, just maybe, she thinks my yoga pants paired with a hoodie and clean-ish Converse shoes along with my ridiculously huge diaper bag that seconds as my purse and kitchen fridge on-the-go are totally adorbs!

I will most likely scrounge up the courage to drag myself to a mirror sometime in the next hour or so just to see what exactly I looked like next to this magical being. Chances are I had green and blue fruit loops bits stuck somewhere between my teeth, a messy bun that closely resembled a bird's nest and overly unplucked eyebrows. Chances are also extremely high there was not a lick of makeup to hide my exhausted, sleep-deprived eyelids, either. My breasts will still be saggy and my tummy will still be loose.

Listen, my seasons will change. All too soon my kids will be older and I will have more energy to prep myself before going out in public. I will be more rested and will probably (hopefully) have lost some pre/post-baby weight. I won't be rushed to pick up peanut butter and milk after school drop-off but before nap. Brushing my teeth in the morning will no longer seem like a luxury. I may even become the "All-Together Woman."

But, in this season, today, I am going to tell myself "I am enough."

Because I AM enough.

My babies don't see her, they see ME, their mommy and #1 person. They love me unconditionally. And I am enough.

My husband respects me as his partner and the mother of his children. He tells me I'm beautiful and loves my body, including all of the wreckage and battle scars left behind from eight babies. And I am enough.

My friends see me for who I am. They know I'm clumsy, goofy and imperfect. And they don't even care that I wear Pajama Jeans. And I am enough.

It is easy (entirely too easy) to look at ourselves as the lesser version of our reality. We can be our biggest critics and shamers. Our own worst enemies.

It's so important that we begin teaching our daughters that they are enough. That who they are in the inside will manifest itself into what they are on the outside. Let's teach our girls, together, to claim their beauty, their strengths and their sense-of-self from within. First and always.

Everything on the outside is literally just the surface. It's time, ladies. And I know you can do it. Because you are enough.

You might also like:

Life
Motherly provides information of a general nature and is designed for educational purposes only. This site does not provide medical advice, diagnosis or treatment.Your use of the site indicates your agreement to be bound by our  Terms of Use and Privacy Policy. Information on our advertising guidelines can be found here.