Treatment for breastfeeding. Pathological conditions of the fetus and hypoxia of the newborn

It can be said that it is advisable for breastfeeding women to avoid drug treatment. However, there may certainly be life situations when mom can not do without drugs. When postpartum complications, with exacerbation of chronic diseases, with the development of serious acute diseases, treatment cannot be delayed.

In such cases, choosing medicines it is necessary to evaluate their toxicity and possible adverse effects on the child's body, after which it is desirable to choose those drugs that are the least toxic and that do not penetrate well into breast milk. It is important to discuss the need and safety of treatment with the prescribing physician. And you should also consult with a pediatrician, specifying the possible side effect medicines for the child.

Below is a summary of data by drug group. Given that there are very few adequate studies, information on many drugs can be contradictory.

Antacids and enveloping. Antacids - drugs that neutralize the acidity of gastric juice, enveloping - drugs that prevent damage to the gastric mucosa. These drugs are prescribed for gastroduodenitis (inflammatory diseases of the stomach and duodenum), with peptic ulcer of the stomach and duodenum.

DENOL. Contraindicated in breastfeeding,

VENTER. May be used with caution.

ALMAGEL, MAALOX PHOSFALUGEL and the like

Antiplatelet agents. Drugs that reduce blood viscosity are used to improve blood circulation in the capillaries when various diseases, for example, with pathology from the heart, blood vessels, kidneys.

CURANTIL. Possible short-term use during breastfeeding.

TRENTAL. Contraindicated.

Antibiotics. They are used to treat various infectious and inflammatory diseases, such as mastitis (inflammation of the mammary gland), endometritis (inflammation of the inner lining of the uterus), salpingo-oophoritis (inflammation of the ovaries and fallopian tubes), tonsillitis, pyelonephritis (inflammation of the kidneys), pneumonia (inflammation of the lungs), with some intestinal infections and etc.

Penicillins (PENICILLIN, AMPICILLIN, AM-PIOX, AMOXICILLIN AMOXYCLAV and others.), cephalosporins (CEFAZOLIN, ZINNAT, CEFOTAXIM, FORTUM, CEFTRIAXONE MAXIPIM, etc.), macrolides(ERYTHROMYCIN, SUMAMED VILPROFEN, MA-CROPEN, etc.), aminoglycosides (NETROMYCIN, GENTAMYCIN, AMIKACIN) are not usually contraindicated in breastfeeding.

Penicillins, cephalosporins, aminoglycosides pass into milk without large quantities, so their toxicity to the child is low. Macrolides penetrate well into milk, but their use during breastfeeding is possible. There is a potential risk of developing complications associated with the occurrence of allergic reactions, disruption of the normal intestinal flora (diarrhea), reproduction of fungi (candidiasis - thrush). For the prevention of dysbacteriosis, it is recommended to appoint a child probiotics (BIFIDUM BACTERIA, LINEX etc.). If an allergic reaction occurs in a child, you should stop taking this antibiotic or temporarily stop breastfeeding.

Tetracyclines, sulfonamides (BACTRIM, BI-SEPTOL and etc.), METRONIDAZOL, clindamycin, lincomycin, levomycetin, ciprofloxacin penetrate into milk, and the likelihood of negative reactions is high. It is recommended to avoid their use during breastfeeding. Side effect clindamycin- risk gastrointestinal bleeding. Side effect LEVOMICETIN - toxic injury bone marrow influence on the cardiovascular system. Side effect tetracyclines- growth retardation, developmental disorder bone tissue and tooth enamel.

Antihypertensive agents. Used for rising blood pressure.

DIBAZOL. Compatible with breastfeeding. Read more - therapeutic effect and indications for the use of dibazol during feeding.

DOPEGIT. Usually not contraindicated in breastfeeding.

VERAPAMIL (ISOPTIN).

ACE inhibitors (ENAP KAPOTEN). There are no adequate studies. Their use during breastfeeding is contraindicated.

DIAZOXIDE. Contraindicated in breastfeeding. Side effect - hyperglycemia (increase in blood sugar).

RESERPINE. Contraindicated.

Antihistamines (SUPRASTIN, TAVEGIL, CETIRIZINE, LORATADIN). Appointed at allergic diseases. The use of these drugs is possible with breastfeeding. Preferred CETIRIZINE, LORATADINE, because antihistamines 1st generation ( SUPRASTIN, TAVEGIL) can cause drowsiness in a child.

ERIES. Contraindicated.

Antidepressants. They are used to treat depression, including postpartum.

AMITRIPTYLINE. The concentration in breast milk is very low. In newborns whose mothers received AMITRIPTYLINE, no abnormalities were observed, therefore this drug is considered compatible with breastfeeding.

There are no studies on other drugs in this group or they are not recommended for breastfeeding.

During treatment postpartum depression antidepressants may be prescribed selective inhibitors reuptake of serotonin FEVARIN (FLUVOXAMINE)), FLUOXETINE, PAROXETINE, SERTRALINE and etc.). According to doctors, these drugs can be used with caution during breastfeeding. However, in the instructions for the drugs, the manufacturer does not recommend their use during breastfeeding, due to the lack of adequate studies.

We analyze the question "Treatment of postpartum depression: antidepressants are not a panacea and how to deal with the problem?"

Anticoagulants. Drugs that prevent blood clotting. Used for increased blood clotting, risk advanced education blood clots, heart disease.

HEPARIN WARFARIN. Usually not contraindicated in breastfeeding, as they pass into breast milk in minimal amounts. With long courses (more than 2 weeks), there is a potential risk of a decrease in blood clotting in a child.

Anticoagulants indirect action (FENILIN). Contraindicated in breastfeeding, taking drugs can cause bleeding.

Antiseptics of local action. Preparations for the prevention and treatment of local infections.

HYDROGEN PEROXIDE, CHLOROHEXIDINE, FUCARZIN, "brilliant green"

Antithyroid drugs. Used for diseases thyroid gland occurring with an increase in its function.

Apply with caution, controlling the condition of the child. Side effect - suppress the function of the thyroid gland of the child.

Benzodiazepines. A group of drugs that reduce anxiety, soothing.

It is believed that a number of drugs from this group ( DIAZEPAM, CLONAZEPAM, LORAZEPAM, DORMIKUM, TEMAZEPAM) is compatible with breastfeeding if used a short time. Side effects - depression of the central nervous system, respiratory depression.

Bronchodilators. Drugs that dilate the bronchi. They are used to stop attacks of bronchial asthma.

SALBUTAMOL, TERBUTALIN, FENOTEROL. It is believed that they are acceptable for feeding. It is necessary to monitor the condition of the child, side effects - excitement, increased heart rate.

Venotonics (DETRALEX). Applicable for venous insufficiency, varicose veins, hemorrhoids. There are no data on penetration into breast milk, therefore it is better to refuse the use of these drugs during breastfeeding,

Vitamins, vitamin-mineral complexes, minerals. Used for breastfeeding. Side effects - allergic reactions.

Hormones(PREDNISOLONE, DEXAMETHASONE, HYDROCORTISONE). Applicable for autoimmune diseases (rheumatoid arthritis, systemic connective tissue diseases, autoimmune hepatitis, etc., with certain blood diseases, with adrenal insufficiency, etc.).

Usually not contraindicated in breastfeeding. However, safety at long-term use has not been proven, therefore, if treatment is necessary for more than 10 days, the issue of continuing breastfeeding is decided individually. If a breastfeeding woman needs long-term treatment a high dose of hormones (2 times more physiological), it is believed that breastfeeding should be avoided.

Thyroid hormones (EUTHIROX). They are used for insufficient thyroid function.

Can be used under the supervision of the child. Side effects - increased heart rate, excitability, diarrhea, decreased weight gain.

Diuretics(diuretics). Used in the treatment hypertension, heart failure, with "renal edema". When using diuretics, there is a risk of lactation suppression, so their use is not recommended during lactation.

The most severe restrictions are set for the group thiazides(HYPOTHIAZIDE), they are contraindicated in breastfeeding.

FUROSEMIDE (LASIX) may be used with caution.

DIACARB indicated for increased intracranial pressure. May be used as concentration in breast milk is too low to cause harmful effect on a child.

Antipyretics.

PARACETAMOL not contraindicated in breastfeeding if used in usual dose and several times (1 tablet up to 3-4 times a day, no more than 2-3 days). Exceeding the dose and long-term use should be avoided, since the side effect of the drug is toxic effect on the liver and blood.

How does paracetamol work and why is it the basis of all antipyretic drugs allowed during feeding: Indications and contraindications for the use of paracetamol during feeding

Choleretic agents. They are used for diseases of the liver and gallbladder, accompanied by stagnation of bile. Not contraindicated in breastfeeding.

(In the instructions for the drug URSOFALC indicated that studies have not been conducted.)

Inhaled corticosteroids (beclomethasone, bbcotide, flixotide and etc.). Used to treat bronchial asthma. Not contraindicated.

Antidiarrheals.

IMODIUM. The drug passes into breast milk, so it is not recommended, but a single dose is possible.

Intestinal sorbents. They are used for poisoning, intestinal infections, allergic diseases.

Activated carbon, SMEKTA, ENTEROSGEL etc. Compatible with breastfeeding.

Contraceptives

During breastfeeding, drugs with a predominant content of progesterone are allowed ( EXCLUTON, MICROLUT. CHAROSETTA, CONTINUINE). Other drugs are contraindicated in breastfeeding.

Gynecologists say in one voice: Allowed contraceptives during breastfeeding

local anesthetics. Used when local anesthesia is needed.

Lidocaine, Articaine, Bupivacaine. Compatible with breastfeeding.

Methylxanthines(CAFFEINE, EUFILLIN). CAFFEINE used to stimulate nervous system, with low blood pressure, is part of drugs with analgesic effect, such as KAFFETIN, CITRAMON. EUFILLIN applies when bronchial asthma to dilate the bronchi.

These drugs are not usually contraindicated while breastfeeding, but should be used with caution. They penetrate well into breast milk and are slowly excreted from the body of the newborn. Side effects - sleep disturbance, agitation, regurgitation, diarrhea, cardiovascular reactions.

Nootropics(means that improve attention, memory) and drugs that improve cerebral blood flow ( STUGERON, PIRACETAM. CAVINTON, TANAKAN, PHENIBUTE, PANTOGAM, GLYCINE and etc.).

The drugs in this group are compatible with breastfeeding.

Painkillers. They can be non-narcotic and narcotic.

Non-narcotic: PARACETAMOL(see above), ANALGIN, KAFFETIN, BARALGIN. Compatible with breastfeeding with single applications. Their long-term administration is not recommended, since the side effect of these drugs is toxic effect on the various bodies(liver, kidneys, blood, central nervous system, etc.).

Narcotic: Morphine, Tramal, Promedol, Naloxone. Penetrate into milk in small amounts, but may cause adverse reactions in newborns. A single dose of these drugs is possible. It is not recommended to take it again, as respiratory depression (apnea), slowing of the heart rate, nausea, vomiting, CNS depression, withdrawal syndrome are possible.

Expectorants. Used for various diseases respiratory system flowing with cough.

AMBROXOL, BROMHEXIN, ACC. Compatible with breastfeeding

Pre- and probiotics (LINEX, PRIMADOPHILUS. HILAK FORTE and etc.). Compatible with breastfeeding.

Prokinetics. They are used for gastroesophageal and duodenogastric reflux - the reflux of contents from the esophagus into the stomach or from the duodenum into the stomach. These conditions can be manifested by symptoms of gastritis (pain in the stomach, heartburn).

MOTILIUM. May be used with caution. Anti-inflammatory drugs.

ASPIRIN. Possible single doses of the drug. Long-term administration and high doses are not recommended, as the risk of serious side effects (decrease in platelets, toxic damage to the central nervous system, liver) increases.

ibuprofen, diclofenac. In a few studies, it was determined that these drugs passed into milk in small quantities and their use did not cause adverse reactions in newborns. However, their long-term administration is not recommended.

NAPROXEN. The effect on the child is not known.

Antihelminthic drugs (DECARIS, PIRANTHEL).

Can be used while breastfeeding.

Antidiabetic drugs.

INSULIN. Usually not contraindicated in breastfeeding, but careful individual dose selection is required. Side effects - the development of hypoglycemic conditions (decrease in blood sugar) in a child.

Oral antidiabetic(hyperglycemic) drugs. Side effects: hypoglycemia up to coma (the likelihood of its development increases if the dosing regimen is violated and the diet is inadequate); nausea, diarrhea, feeling of heaviness in the stomach. Sometimes: skin rash, itching, fever, joint pain, proteinuria. Rare: sensory disturbances, headache, fatigue, weakness, dizziness, pancytopenia; cholestasis, photosensitivity.

Contraindicated in breastfeeding.

Antiemetic drugs.

CERUKAL. Compatible with breastfeeding for short-term use.

Antiulcer drugs. Drugs that block the secretion of acid in the stomach.

omeprazole. No research.

RANITIDINE, FAMOTIDINE HISTODIL. Side effects - headache, dizziness, fatigue, skin rash, effect on the blood picture. Cases of development of hepatitises are described. The drugs are contraindicated in breastfeeding.

Psychotropic drugs. They are used for psychoses, neuroses ( AMINAZINE, DROPERIDOL, HALO-PERIDOL, SONAPAX and etc.).

They pass into milk in small amounts, however, since there is a risk of developing serious side effects, they are not recommended for breastfeeding without absolute indications. Side effects - depression of the central nervous system, impaired development of the nervous system.

Laxatives.

FORLAX, GUTTALAX, REGULAX, SENNA LEAVES. Compatible with breastfeeding in moderate doses.

Antispasmodic drugs.

NO-SHPA. Use during breastfeeding is possible.

Uroseptics and intestinal antiseptics. They are used to treat infectious and inflammatory diseases of the kidneys and intestines.

FURGIN. There are no adequate studies. According to the instructions - not recommended.

FURAZOLIDONE, MACMIROR, ENTEROFURIL, FURADONIN May be used with caution.

Nalidixic acid (NEGRAM, NEVIGRAMON). May be used with caution.

Enzymes. They are used to improve digestion in various gastrointestinal diseases.

MEZIM FORTE, CREON etc. Compatible with breastfeeding.

Of course, mother's milk is the most useful and proper food for a newborn baby. But, unfortunately, it happens that for some reason breastfeeding has to be abandoned. In what cases should you not breastfeed and why do you have to resort to such extreme measures? There are absolute contraindications, in which breastfeeding is categorically not allowed, and relative (temporary), in which breastfeeding is prohibited only for a while.

Mom's problems

Absolute contraindications to breastfeeding

It is absolutely contraindicated to breastfeed with the following diseases:

HIV infection. HIV infection can be transmitted through breast milk and is a contraindication for breastfeeding. It is now established that an HIV-infected woman can infect a child through breast milk with a probability of 15%. Despite the statement World Organization(WHO) and UNICEF, which was published in September 1999, which supports the freedom of HIV-positive mothers to choose their own feeding methods. baby, in our country, in such cases, doctors recommend feeding children with milk mixtures, and not breast milk.

Open form of tuberculosis. An open form of tuberculosis, in which a woman secretes Mycobacterium tuberculosis and can infect others, is a contraindication for breastfeeding a baby. In this case, the mother, before breastfeeding the child, must undergo a full course of treatment with anti-tuberculosis drugs. And only after the end of treatment, after 1.5-2 months, you can start breastfeeding your baby. And if the disease is in active form and does not require treatment, then breastfeeding is allowed.

Relative contraindications for breastfeeding

If absolute contraindications occur quite rarely, then relative ones are a more common phenomenon.

The need for medication. Sometimes a woman's health condition requires constant medication. In this case, when choosing a drug, it is necessary to take into account not only its degree of effectiveness for the mother, but also the safety for the child. Breastfeeding should be stopped if the mother is forced to take drugs that are incompatible with breastfeeding: for example, certain antibiotics, antidepressants, hormonal agents, antiviral drugs, etc. Of course, if possible, the doctor will try to find medicines that can be used when breastfeeding the baby, but in practice this does not always work out.

Aggravation serious illnesses mothers. In some cases, the mother's body is not able to provide good nutrition for a baby due to severe metabolic disorders, for example, with severe cardiovascular diseases(chronic heart failure, severe heart rhythm disturbances, etc.), kidney problems (acute or chronic renal failure), liver problems, severe forms of diabetes, etc. The problem is that breastfeeding can lead to a deterioration in the general condition of a woman, therefore, in such cases, the question of maintaining lactation and returning to breastfeeding is decided by the doctor individually after treatment and stabilization of the woman's condition.

Complications during and after childbirth. If during or after childbirth a woman begins heavy bleeding, you must first restore the health of the mother, and then start breastfeeding the baby.

Mastitis. In cases where a woman develops mastitis (inflammation of the mammary gland), it is recommended to continue breastfeeding, as the breast needs constant and thorough emptying. If antibiotics must be taken to treat mastitis, then drugs that are compatible with breastfeeding should be chosen. If this problem is not dealt with in time, then mastitis can become more complicated - pus will accumulate in the mammary gland and an abscess will develop (to find out if there is pus in the milk, you need to express some milk onto a cotton swab, while it will be absorbed, but the pus will not. To confirm diagnosis is performed by ultrasound of the mammary glands). If pus is found in the milk, it is impossible to feed the baby with this breast, but you need to continue to apply the baby to a healthy mammary gland. Milk from an infected breast will need to be carefully expressed and discarded.

Herpes. Herpes simplex viruses are not transmitted through breast milk. So if the mother does not have an exacerbation of this disease, then you can breastfeed the baby. Danger for a child can arise only with direct contact between the area of \u200b\u200bthe chest on which the herpes rash appeared and the baby's mouth. It is clear that until the affected area is healed, it is impossible to breastfeed the baby. Mom is assigned antiviral treatment after which she can return to breastfeeding.

Hepatitis B and C. Previously, there was an opinion that when breastfeeding, hepatitis B and C viruses can enter the baby's body. However, when studying this problem, it turned out that the main contact with these viruses occurs when the child passes through birth canal. But with breastfeeding, the risk of infection of the baby is extremely low, so there is no need to refuse breastfeeding. A nursing mother with hepatitis B or C should carefully monitor the condition of the nipples when feeding. Any microtrauma of the nipples and contact of the child with mother's blood increase the risk of infection. In this case, breastfeeding should be stopped until the nipples heal.

Child problems

Absolute contraindications for breastfeeding

It happens that breastfeeding is banned not because of the mother, but because of the baby himself. There are a number of conditions in which the baby should not receive breast milk, and he is prescribed a special therapeutic mixture.

This includes a whole group of congenital hereditary metabolic disorders: galactosemia, phenylketonuria, maple syrup disease. With these diseases, there is no enzyme in the body of the crumbs - this does not allow the components to be properly broken down breast milk and leads to illness in the child.

Galactosemia. The disease is based on a deficiency of an enzyme that is involved in the conversion of galactose to glucose. With this metabolic disorder, the child is strictly contraindicated in milk and milk formulas based on cow's milk. Goat milk and goat milk formulas are also contraindicated for a baby with galactosemia. As food, it is recommended to use special artificial mixtures based on soy protein or casein hydrolyzate.

Phenylketonuria. This disease is associated with a violation of the metabolism of the amino acid phenylalanine. To prevent the development of the disease, it is necessary to exclude this amino acid from the nutrition of an infant. It is contained in breast milk in small quantities, so breastfeeding is possible under strict control of the level of phenylalanine in the child's blood. With its increase, breastfeeding has to be limited, and several feedings are replaced with special adapted milk formulas that do not contain phenylalanine. How many times a day and how much you can breastfeed a baby, the pediatrician decides, taking into account general state baby and the level of phenylalanine in the blood.

Maple syrup disease. This disease is caused by a violation of the metabolism of the amino acids leucine, valine and isoleucine. In breast milk, these amino acids are present in a very small amount, therefore, as in the case of phenylketonuria, it is possible to breastfeed the baby, but in limited quantities, replacing part of the feeding with artificial milk mixtures that do not contain "unnecessary" amino acids.

Temporary contraindications to breastfeeding

Exists whole line deviations in the health of the baby, in which a restriction is imposed on breastfeeding until the child's condition returns to normal. Most often, problems occur in weakened children, due to the unfavorable course of pregnancy and difficult childbirth. So, breastfeeding will have to wait:

if the assessment of the state of the newborn on the Apgar scale is below 7 points;
with deep prematurity;
if the birth weight of the child is less than 1500 g;
with respiratory distress syndrome, birth trauma and convulsions in the baby;
with congenital heart defects with severe heart failure of the child.

In all these cases, breastfeeding, which requires a lot of effort from the baby, can lead to a general deterioration in his condition.

With prematurity and severe damage to the nervous system, the problem for breastfeeding, as a rule, is that due to the slow maturation of the centers in the brain, by the time of birth, the child does not have (or is poorly expressed) sucking and swallowing reflexes. The baby is simply not yet able to coordinate breathing, sucking and swallowing, which is necessary for proper capture and sucking of the breast. In addition, under these conditions, newborn babies are very weak and it is simply difficult for them to suckle at the breast.

When attachment to the breast is not possible for any reason, the baby should receive expressed breast milk. The question of when it will be possible to resume breastfeeding is decided together with the doctor individually in each individual situation, and it depends, first of all, on the condition of the child.

Separately, there are birth defects development, like the cleft palate and cleft lip (cleft lip, hard and soft palate). At the same time, there are difficulties associated with putting the baby to the breast and the sucking process itself. In this situation, the baby is fed with expressed breast milk special devices for feeding. After surgical treatment breastfeeding can be restored on the recommendation of a doctor.

How to restore breastfeeding

If a mother is unable to breastfeed for any reason, she must pump regularly to maintain lactation. Pumping is a kind of signal for the body, reporting the need to produce milk. If the baby is fed with expressed milk, then the mother should express her breast immediately before feeding. If the baby is temporarily switched to formula milk, the mother needs to pump her breast every three hours, including at night. With more infrequent pumping, the amount of milk will decrease, and when it is possible to return to breastfeeding, the baby will miss it.

If it is necessary to feed the baby with expressed breast milk, it should be given from a spoon, syringe (without a needle) or a cup. It is important not to teach your baby to suck from a bottle so that later he does not refuse the breast.

So, the time has finally come when mom can start or resume breastfeeding. Where to start?

The most important thing is the confidence of the mother that she will succeed!

The process of restoring lactation includes several basic steps. First, you need to often apply the baby to the breast. The child should be able to breastfeed as often and for as long as he wants, while night feedings are also required. Secondly, very important body contact mother and child during the day (it is convenient to use a sling for this), joint sleep at night.

That is, the task of the mother at this stage is to ensure almost continuous contact with the child and regularly offer him breasts. At the same time, it is necessary to ensure that the baby is correctly applied to the breast, since the effectiveness of stimulation and emptying of the mammary gland and, accordingly, the full production of milk depends on this.

Hemolytic disease: to breastfeed or not?

Hemolytic disease of the newborn, which occurs with Rhesus or blood type conflict, is not a contraindication for breastfeeding. In the past, it was common practice to cancel breastfeeding due to the presence of anti-Rhesus antibodies in the mother's blood. Since these substances are the cause of the destruction of the red blood cells (erythrocytes) of the child, doctors feared that their additional intake with mother's milk could aggravate jaundice in the baby and worsen his condition. Currently, studies have shown that Rh antibodies are destroyed in the gastric juice of the newborn and breastfeeding does not increase the breakdown of red blood cells. Therefore, a baby with hemolytic disease can be applied to the breast already on the first day.

Treatment of cystitis, thrush, sinusitis, constipation, diarrhea, tonsillitis, cough and other diseases during lactation

Diet ( food) during lactation

During breastfeeding, a nursing mother is shown a complete and varied diet, ensuring the intake of all the necessary vitamins and microelements into the body. It is recommended that a woman eat 5-6 times a day in small portions, which will prevent the development of nausea or vomiting. All food taken should be fresh and well processed ( thermally and physically), which will minimize the risk of developing foodborne infections that can disrupt the process lactation.

In addition, it is extremely important to ensure the supply of sufficient amounts of fluid to the body, since dehydration ( loss of large amounts of fluid) may be accompanied by a decrease in the amount of breast milk produced.
At normal temperature air, a nursing woman is recommended to consume at least 2.5 liters of fluid per day ( in the absence of diseases of the cardiovascular system, edema and other contraindications), and in the heat - about 3 - 4 liters.

Products that increase ( improving, stimulating) lactation

There are a number food products, the regular use of which can stimulate ( intensify) the process of producing breast milk. It should be noted right away that it is also not recommended to take these products in large quantities, as this can lead to the development of a number of adverse events (nausea, vomiting, allergies, etc.).

Increase lactation contribute to:

meat broths ( lean meats such as turkey);
cheeses;
carrot juice;
cheese ( cow or sheep);
fresh milk ;
dairy products;
buckwheat;
herculean porridge;
wheat porridge;
dried fruit compotes;
fresh juices;
jelly;
sunflower seeds .

Do walnuts increase lactation?

By themselves, walnuts do not stimulate the production of breast milk, but they significantly affect its quality. Walnuts contain a large amount of fat and protein, as well as many calories needed by a nursing mother. Eating 4-5 nuts per day will provide the body with iodine and other trace elements, as well as vitamin C, which is contained in large quantities in nut kernels.

At the same time, it should be noted that in the core walnut contains essential oil. Although its proportion is relatively small, it can be included in the composition of breast milk and, together with it, penetrate the body of a newborn child, thereby causing the development of allergic reactions in him ( skin rash). Here's Why You Shouldn't Overeat Nuts While Breastfeeding that is, you do not need to take them in large quantities), and if the child has signs of allergy, it should be completely excluded this product from the diet.

Products that reduce ( reducing) lactation

During the period of weaning the child from the breast ( or to reduce lactation for other reasons) it is also recommended to follow a certain diet, which, in combination with other activities, will reduce the amount of milk produced. First of all, all foods that can stimulate lactation should be excluded from the diet ( they are listed earlier). You can also slightly limit the amount of fluid taken per day ( about 30%). This will not have a significant impact on the health of the mother, but will contribute to the suppression of lactation. In addition, you can eat special products that will inhibit the production of breast milk.

The suppression of lactation can contribute to:

spices;
diuretic herbs ( lemon balm, linden, St. John's wort);
black pepper;
smoked products;
canned food.

It should be noted that when using these products ( especially spices and smoked meats) the taste of breast milk changes significantly, which can contribute to weaning the baby from the breast. At the same time, it is important to remember that the use of such milk by a baby can cause allergic reactions in him, as well as disorders of the gastrointestinal tract ( intestinal colic, diarrhea or vomiting). That is why doctors advise limiting or completely eliminating breastfeeding when using these foods to suppress lactation.

Can I drink coffee while lactating?

Coffee contains the substance caffeine, which, when ingested human body affects the cardiovascular system in a certain way ( increases heart rate and constricts blood vessels, thereby increasing blood pressure). Caffeine also stimulates the central nervous system ( CNS) person.

If a nursing woman drinks coffee, some of the caffeine that enters her body is included in breast milk and can enter the baby's body with it. However, it is worth noting that with reasonable coffee consumption, the concentration of caffeine in milk is negligible. So, for example, when drinking 1 cup of coffee ( containing about 100 mg of caffeine) about 0.5 mg of this substance will enter the breast milk of a woman. This is too little to in any way affect the cardiovascular system or the central nervous system of the child. That is why breastfeeding women can drink 1-3 cups of coffee a day without fear of harming the baby.

At the same time, coffee consumption in large quantities ( 5 or more cups per day) may be accompanied by a pronounced increase in the concentration of caffeine in breast milk, which can lead to the development of complications in the child. This can manifest itself as an increase in heart rate and an increase in blood pressure, anxiety, tearfulness, and so on.

Can I drink alcohol during lactation?

You can drink alcohol while breastfeeding only in limited quantities. The fact is that ethyl alcohol, which is part of alcoholic beverages, easily penetrates into breast milk, and therefore can enter the child's body with it. However, with moderate alcohol consumption, the concentration ethyl alcohol in milk will be relatively small. Moreover, this alcohol is very quickly excreted from the mother's body, which also limits its effect on lactation and on the child. It has been scientifically proven that after drinking a glass of wine or a can of beer, a woman can breastfeed her baby after 3 hours, without fear of harming the baby's health.

At the same time, it is worth remembering that the use of strong alcoholic beverages ( vodka, cognac and so on) in large quantities is accompanied by a pronounced increase in the concentration of ethyl alcohol in the mother's blood and in her breast milk. In this case, an increased concentration of alcohol can persist for 5–10 or more hours, which depends on the amount of alcohol taken, as well as on the condition of the patient's liver ( alcohol is detoxified in the liver). If, after drinking a large amount of alcohol, a woman breastfeeds a child, part of the alcohol will enter the child's body along with breast milk, which will cause him a series of side effects associated with the effect of ethyl alcohol on the central nervous system and other organs. This can be manifested by severe drowsiness and lethargy of the child, a decrease in his immunity ( the body's defenses), liver and kidney diseases ( with prolonged intake of alcohol in the body) and so on. In addition, these children may develop an increased resistance to alcohol, which will contribute to the development of alcoholism in them ( pathological addiction to alcoholic beverages) in adulthood.

Complications of lactation ( cracked nipples, milk stasis, mastitis)

Lactation is a physiological process, which, however, can be complicated by unpleasant diseases and pathological conditions.

The development of complications during lactation can contribute to:

not regular feeding child;
maternal malnutrition;
non-compliance with the rules of personal hygiene by the mother;
decreased immunity in the mother.

Lactation can be complicated:

Cracked nipples. Cracked nipples can appear after the start of feeding a child in almost any woman ( especially in the presence of predisposing factors listed above). The appearance of cracks is accompanied by severe pain in the nipple area, especially during feeding. This can negatively affect a woman's central nervous system, resulting in a decrease in her milk supply ( Or will it disappear altogether). In addition, in the area of the crack, the protective properties skin, which creates favorable conditions for infection.
Stagnation of milk. Under normal conditions, milk is secreted from the ducts of the lobules of the mammary gland with each feeding or pumping. If for a long time ( 2 – 3 days) milk is not removed from a certain segment ( for example, during a break in feeding, after an injury, and so on), it thickens and clogs the excretory duct. At the same time, the newly formed milk cannot be released outside, as a result of which it stagnates in the breast tissue, which manifests itself painful induration. To eliminate this pathology, it is recommended to apply the baby to the affected breast more often, regularly massage the gland, and, if necessary, express milk. If the disease does not go away within 2 days, as well as with the development infectious complications (accompanied by fever and increasing pain in the area of the affected gland) it is recommended to consult a doctor immediately.
Mastitis. This is an inflammatory lesion of the mammary gland, accompanied by its pronounced soreness, enlargement and thickening of the breast tissue, as well as possible increase body temperature and other infectious complications. Nipple cracks can contribute to the development of mastitis ( through which the infection can penetrate into the tissue of the gland), as well as milk stagnation, which disrupts blood microcirculation and creates optimal conditions for development pathogenic microorganisms. To treat mastitis, it is necessary to regularly empty the gland from milk, as well as monitor compliance with the rules of personal hygiene. With the development purulent complications may require the use of antibiotics or surgical opening of the abscess ( breastfeeding for the duration of treatment in this case will have to stop).

painful lactation ( Why do nipples and breasts hurt during lactation?)

In itself, the process of breastfeeding a child may be accompanied by minor pain in the nipple of the breast, but under normal conditions, these pains practically do not cause any concern to the mother. At the same time, it is worth remembering that with the development of certain diseases and pathological conditions, breastfeeding can become extremely painful. So, for example, the cause of soreness in the nipple area can be nipple cracks, as well as damage to the nipple area with the child's teeth ( what can be observed when breastfeeding children older than 1 year). The appearance of bursting pain in the area of the mammary gland may accompany the stagnation of milk in it ( lactostasis), as well as the development of mastitis ( in this case, the pain syndrome becomes more pronounced, the pain intensifies while feeding the child or when touching the skin over the inflammation).

If pain occurs in the mammary gland during lactation, the cause of their occurrence should be identified and eliminated as soon as possible, otherwise the risk of developing infectious complications increases, which can adversely affect the health of the mother, as well as the lactation process itself.

Why do seals appear in the mammary gland and the chest hurts after lactation is completed?

Painful seals in the chest can occur as early as a day after the abrupt cessation of breastfeeding, especially if before that the child was regularly breastfed. At the same time, milk will continue to be produced and accumulate in the mammary glands, squeezing the surrounding tissues and clogging excretory ducts lobule of glands. The pain in this case will be bursting, aching in nature and intensify with pressure on the chest.

To prevent the accumulation of milk and the appearance of pain, it is recommended to wean the baby from the breast gradually, for several weeks in a row, reducing the number of attachments to the breast and increasing the proportion of complementary foods. At the same time, the amount of milk produced will also gradually decrease. If in this case pain does occur, they will be moderate and disappear on their own within a few days.

If it is impossible to gradually wean the child from the breast, with the appearance of arching pains, it is recommended to express breast milk daily. This will temporarily reduce the severity of the pain syndrome, as well as prevent milk stagnation and the development of infectious and inflammatory complications. In the future, to suppress lactation, you can use medication or folk remedies ( pills, herbs, infusions and so on).

Why do browns appear ( bloody) discharge from the breast during lactation?

Brown discharge from the nipples during lactation may indicate the presence of any pathological process in the mammary gland. The resulting discharge is milk, Brown color which is tainted with blood.

The reasons for the appearance brown discharge during lactation may be:

Cracked nipples. The formation of cracks may be accompanied by a violation of the integrity of tissues and damage to small blood vessels, the blood of which can mix with the secreted milk, giving it a brown color.
Nipple injury. While breastfeeding older than a year they can damage the nipple with erupting teeth, as a result of which blood can also enter the milk.
Stagnant milk. With stagnation of milk ( lactostasis) there is compression of the surrounding tissues and a violation of microcirculation in them, which can also be accompanied by damage to small blood vessels and the ingress of a small amount of blood into the duct of the breast lobule. With the resolution of lactostasis, the secreted milk may have a brown tint.
Inflammatory diseases of the breast ( mastitis). If the development of mastitis is complicated by the formation of a purulent focus ( abscess), pus can destroy blood vessels and get into the lobules of the mammary glands, which will be accompanied by the release of a brown-gray purulent mass from the nipple. In this case, the patient will experience severe pain, and she will also have an increase in body temperature and pronounced redness of the skin over the affected mammary gland, which will distinguish this pathology from other, less dangerous complications.

Is it possible to have sex while lactating?

Sex during lactation is not prohibited. Moreover, it can help improve lactation and maintain it. The fact is that immediately after the end of sexual intercourse in the body of a woman ( and men) there is a short-term increase in the concentration of the hormone prolactin, which stimulates the production of breast milk. Be that as it may, having sex does not have any negative effect on lactation.

At the same time, it is worth remembering that childbirth through the birth canal is an extremely traumatic process, after which the woman's external genitalia must recover. That's why it's not recommended to renew sexual life for at least 1-2 months after the birth of the child.

Is it possible to get pregnant during lactation?

If, after the birth of a child, you regularly feed him exclusively with breast milk, it is impossible to get pregnant. It is used by many women as a method of contraception ( preventing pregnancy). At the same time, with breaks in feeding, as well as with the introduction of complementary foods or supplementary foods ( when the baby starts supplemental formula feeding) efficiency this method contraception is sharply reduced, in connection with which pregnancy may occur.

The mechanism of action of lactation as a method of contraception is based on hormonal changes occurring in the female body. For pregnancy to occur, it is necessary that a woman's ovaries develop and mature in her ovaries. sex cell (egg). For this to happen, from the pituitary gland ( a special gland located in the brain that produces various hormones) 2 hormones should be secreted - follicle-stimulating hormone ( FSH) and luteinizing hormone ( LG). Without them, the maturation of the egg is impossible. However, during breastfeeding, irritation of special nerve receptors in the area of the nipple of the mammary gland stimulates the production of another hormone - prolactin. Prolactin ensures the formation of milk in the mammary gland, at the same time, inhibiting the formation of FSH and LH in the pituitary gland, thereby preventing the development of the female germ cell and making pregnancy impossible.

An important condition for maintaining the process described above is the regular attachment of the child to the breast, which ensures that the concentration of prolactin in the blood is maintained at a sufficiently high level. If you take breaks in feeding ( even before the child reaches the age of 6 months), this may be accompanied by a periodic decrease in the concentration of prolactin. As a result of this, FSH and LH may begin to be released, which will start the process of maturation of the female germ cell. If the woman then has sex without using other methods of contraception, she may become pregnant.

Signs of pregnancy during lactation

It can be extremely difficult to detect early signs of pregnancy during lactation. This is due to the fact that these signs can be due to both the onset of a new pregnancy and changes in the female body associated with recent childbirth or with the lactation process.

The presence of pregnancy during lactation may indicate:

unreasonable nausea;
vomit;
taste change;
breast enlargement ( observed during lactation, so it cannot be considered a reliable sign);
soreness in the nipples ( may also occur during breastfeeding);
increased appetite;
frequent urination ( associated with bladder compression by a growing fetus);
an increase in the abdomen;
disappearance of menstruation can only indicate pregnancy if, after the birth of the child, the woman's menstrual cycle was restored).

If pregnancy is suspected, a diagnostic test is recommended ( pregnancy test), which allows to confirm or refute the diagnosis with certainty.

Why do lymph nodes become inflamed during lactation?

Inflammation of the lymph nodes during lactation can be observed with the development of mastitis ( breast inflammation) or other infectious complications.

Lymph nodes are a kind of filters through which lymph ( fluid found in almost all tissues of the body) flows away from tissues. If an infection enters the tissues, the infectious agents or their toxins linger in the immediate lymph node. The immune cells located there protective) systems begin to actively fight the source of infection, which is accompanied by their active division and an increase in the size of the lymph node.

From the mammary gland, lymph flows into the axillary lymph nodes. With the development of mastitis, as well as when infection enters the breast tissue ( for example, through cracked nipples) infectious agents will quickly enter the axillary lymph nodes, which will be accompanied by their painful increase. In this case, you should consult a doctor as soon as possible and start a specific treatment for the disease, since with further development infections, bacteria and their toxins can enter the systemic circulation, which can lead to the development of much more severe, life-threatening complications.

How long after lactation do periods start?

Period ( bleeding associated with a woman's menstrual cycle) may begin as early as a few months after childbirth, or may be absent for six months or more after the birth of a child. Their appearance directly depends on the nature and duration of breastfeeding.

Under normal conditions, a high concentration of the hormone prolactin in the blood of a woman is necessary to maintain lactation. This is ensured by regularly applying the baby to the breast and irritating the corresponding nerve receptors, which triggers the synthesis of the hormone in the pituitary gland. Prolactin inhibits the development of the female germ cell in the ovaries, thereby disrupting menstrual cycle and preventing the onset of menstruation. Therefore, than longer woman breastfeeds the baby regularly), the later she gets her period.

If you stop breastfeeding, after a few weeks another egg may begin to mature in the ovaries ( female sex cell), which can soon lead to the appearance of menstruation.

Why do menstruation occur during lactation?

The appearance of menstruation during lactation may be due to insufficient levels of the hormone prolactin in the woman's blood. As already mentioned, under normal conditions, after the birth of a child, regular feeding ( attachment to the chest) stimulates the production of prolactin ( necessary for the formation of milk), which suppresses the development of menstruation. During breaks in feeding, as well as with a weakly pronounced sucking reflex in a child, the concentration of prolactin in the blood will fluctuate ( drop periodically), which will create favorable conditions for the growth and development of the female germ cell and subsequent menstrual bleeding.

Hair loss during lactation

By itself, lactation does not affect the process of hair growth and is not the cause of hair loss. At the same time, hair loss during breastfeeding may be associated with changes and disorders that develop in the female body after pregnancy and childbirth.

The cause of hair loss during lactation can be:

Hormonal changes in the body. In particular, fluctuations in the level of female sex hormones observed before and after childbirth.
Lack of nutrients and vitamins. During childbearing, some trace elements and vitamins ( in particular iron, folic acid and vitamin B12) passes from the mother to the fetus. During feeding, these substances are also passed to the baby along with breast milk. If at the same time the woman does not receive increased amount proteins, fats, vitamins and microelements with food, a number of disorders can develop in her body, one of which will be hair loss.
Stress and nervous strain. Stress during childbirth chronic sleep deprivation during the first months after them, it can disrupt the functions of the central nervous system and the endocrine system, which can also be accompanied by a violation of trophism ( nutrition), increased fragility and hair loss.
Wrong hair care. Paying all attention to a newborn child, a woman can deprive herself and her hair of attention. Infrequent shampooing, poor combing, and stopping the use of nourishing balms and other similar substances can contribute to hair loss in postpartum period.

Is it possible to sunbathe / visit a solarium during lactation?

Sunbathing or visiting a solarium during lactation is not prohibited, since under normal conditions this will not affect the lactation process in any way. At the same time, it is worth remembering that excessively strong irradiation of the body ultraviolet rays (responsible for sunburn) can contribute to skin damage, skin burns, and so on. Skin burn in the sun is quite a powerful stress factor for female body, especially in the early postpartum period, when its defenses are weakened. In severe cases, this can lead to disruption of the endocrine system and hormonal disorders, accompanied by disorder ( weakening or stopping) lactation. To prevent development this complication, nursing women should sunbathe carefully, visiting the beach only in the morning or evening hours ( before 10 am and after 6 pm) and not being under the action of direct sun rays for too long.

What medicines can be taken during lactation ( antibiotics, antihistamines, antivirals, sedatives, activated charcoal)?

If during lactation any disease or pathological condition develops that requires medical treatment, it is important to know which drugs can be combined with breastfeeding and which cannot. The fact is that most drugs have the ability to penetrate into breast milk and enter the child's body with it, causing the development of adverse reactions in the baby.

During lactation, you should be careful when taking:

antibiotics. The drugs of choice during lactation include penicillins ( augmentin, amoxicillin). They penetrate into milk in very small concentrations, and therefore, when using them, you can continue to breastfeed your baby. However, it is important to remember that even a small amount of an antibiotic in breast milk can be enough to cause an allergy in a child. When using other antibacterial drugs, as well as when a child develops an allergy to penicillin antibiotics you should refrain from breastfeeding for the entire period of treatment. At the same time, milk should be expressed regularly so as not to disturb the lactation process and resume feeding the child immediately after stopping the medication.

antihistamines ( suprastin, cetirizine). These drugs are used to treat allergic reactions. They easily penetrate into breast milk and can harm the baby's body, affecting its central nervous system, cardiovascular system, blood system, sensory organs, and so on. That is why it is recommended to interrupt breastfeeding during treatment with these drugs.
Antiviral drugs. During the use of antiviral drugs, it is also recommended to stop breastfeeding the baby. An exception may be preparations based on interferon ( natural component, which is part of the protective cells immune system human). The mechanism of their action is to enhance the natural protective ( antiviral) forces of the body, and they themselves have practically no negative effect on breast milk or on the child.
Sedatives. The mechanism of action of most sedatives is to inhibit the functions of the central nervous system, which reduces nervous tension and makes it easier to fall asleep. If such substances enter the body of a child with mother's breast milk, this can lead to severe depression of the baby's central nervous system and the development of a number of complications ( drowsiness, lethargy, lethargy, and with prolonged use - to a lag in mental and physical development). That is why it is not recommended to use any sedative medications during lactation.

During lactation, it is not forbidden to take activated charcoal and other similar drugs prescribed for intestinal infections and poisoning. Their mechanism of action is that they bind toxic substances in the patient's intestines and contribute to their speedy removal from the body. Activated charcoal itself is not absorbed through the mucous membrane of the gastrointestinal tract and does not enter the mother's breast milk, and therefore is absolutely harmless to the child.

Complications may develop with long-term regular use of this drug, as this will disrupt the absorption of nutrients in the intestine, which may be accompanied by a weakening or cessation of lactation. That is why activated charcoal should be used in short courses ( no more than 3 consecutive days) and only if there is evidence ( i.e. signs of food poisoning or intestinal infection).

Painkillers for headache and toothache during lactation ( paracetamol, nurofen, ibuprofen, diclofenac, citramon, nimesil, analgin)

For severe headaches or other pain, you can take some pain relievers that are not excreted in breast milk ( or are released in negligible concentrations) and practically do not affect the body of the child. At the same time, it is worth remembering that if the pain syndrome does not disappear after 1-2 days of using such drugs, you should consult your doctor.

For headaches and other pains, you can take:

Paracetamol (500 mg orally up to 4 times a day). About 0.2% of the drug is excreted in a woman's breast milk, but it has minimal effect on the child.
ibuprofen, nurofen (inside 200 - 800 mg 2 - 3 times a day). This drug allowed to be taken during lactation, despite the fact that a small part of it still enters the mother's breast milk.
diclofenac(inside 25 - 50 mg 2 - 3 times a day). It is allowed to take only if it is not possible to use other painkillers.

During lactation, it is not recommended to take:

Citramon. Its composition includes acetylsalicylic acid (aspirin, contraindicated in lactation), as well as caffeine, which can enter the baby's body with mother's breast milk and negatively affect his cardiovascular and central nervous system.
Nimesil. It can penetrate into the body of a child with breast milk, leading to impaired renal function.
Analgin. It can penetrate the child's body and affect his hematopoietic system.

Contraception during lactation ( Can I take contraceptives while breastfeeding?)

As stated earlier, regular breastfeeding is in itself a reliable method of contraception ( preventing pregnancy). At the same time, to protect yourself especially after the introduction of complementary foods), women can use other methods of contraception. The method of choice in this case will be a condom, since it will absolutely not affect the process of producing breast milk.

For the treatment of hemorrhoids, you can use:

Relief candles. Should be entered in anus 1 candle 4 times a day. They have anti-inflammatory and wound healing effects. The drug is not contraindicated in lactation.
Candles hepatrombin G. Combined drug with anti-inflammatory action, which prevents the formation of blood clots ( blood clots ) in dilated veins, thereby contributing to speedy recovery female patients. Suppositories should be inserted into the anus after each act of defecation ( but no more than 2 times a day). The drug is not contraindicated in lactation.
Sea buckthorn oil ( candles). Has a wound healing effect. For the treatment of hemorrhoids, 1 suppository should be injected into the anus ( 500 mg) 2 times a day. Can be used during lactation.
Heparin ointment. Used for application to hemorrhoids (for the treatment and prevention of thrombosis). Heparin does not penetrate into breast milk, and therefore is not contraindicated in lactation.

Is it possible to use vasoconstrictor nasal drops during lactation?

Use vasoconstrictor drops for the nose ( xylometazoline, naphthyzine and others) should only be taken after consulting a doctor.

These drops are used for nasal congestion, which can be observed with colds, allergic reactions and so on. The mechanism of their action is associated with the narrowing of blood vessels and the elimination of swelling of the nasal mucosa, which facilitates nasal breathing. This does not affect the lactation process in any way, however active ingredients drops can enter the systemic circulation ( in very small quantities) and be excreted from the mother's body with breast milk, which can lead to the development of allergic and other undesirable reactions in the child. However, no studies demonstrating harm vasoconstrictor drops for a child during breastfeeding, has not been carried out. In the presence of strict indications drugs can be used to relieve nasal congestion, but only in short courses ( no more than 2 - 3 days).

Do I need to take iron while lactating?

Iron is essential for many physiological processes in the body, in particular for the formation of red blood cells ( erythrocytes) that transport oxygen. Pregnancy and breastfeeding are risk factors for the development of iron deficiency in the body. This is due to the fact that part of the iron reserves from the female body is transferred to the fetus, part is lost during blood loss ( during childbirth), and part is passed to the baby along with breast milk during lactation. Therefore, in order to prevent the development of iron deficiency and related complications ( in particular anemia, anemia, hair loss, skin lesions, and so on), a woman should start taking iron supplements from the first months of pregnancy until childbirth, as well as during lactation and for several months after its termination ( to replenish iron stores in the body).

To prevent iron deficiency during pregnancy and lactation, you can take:

Hemopher prolongatum- inside 100 - 200 mg 1 time per day.
Sorbifer durules- Inside, 1 - 2 tablets per day.
Ferro-foil- inside 1 - 2 capsules twice a day ( after meal).

Vitamins ( B6, B12, D) during lactation

Breast milk is fortified with all necessary for the child nutrients, including vitamins. Vitamins can enter milk only from the mother's body. Therefore, for the correct and complete feeding of the baby, a woman must also receive all the vitamins and minerals in sufficient quantities.

Most vitamins enter the mother's body with food ( with a nutritious and varied diet). At the same time, some vitamins should be administered additionally in the form of medicines, since the need for them during lactation increases.

During lactation, a woman can be prescribed:

Vitamin B6. Takes part in metabolism, and is also necessary for the normal formation of red blood cells ( red blood cells). The daily requirement during lactation is 2.2 mg.
Vitamin B9 ( folic acid). This vitamin is necessary for ensuring the processes of cell division throughout the body. The daily requirement for it during lactation is 300 micrograms.
Vitamin B12. This vitamin is essential for normal exchange substances in the body, as well as to prevent the development of anemia ( anemia). The daily requirement during breastfeeding is 2.8 micrograms.
Vitamin D. Required for normal development bone tissue, as well as normal functioning immune ( protective) body systems, for metabolism and so on. During lactation, a woman should receive at least 600 International Units of vitamin D per day.
Vitamin C ( vitamin C ) . It is necessary to ensure metabolism at the cellular level, as well as to maintain the strength of the walls of blood vessels, for the synthesis of many biologically active substances, and so on. When breastfeeding daily requirement in this vitamin is 120 mg.

Treatment of cystitis, thrush, sinusitis, constipation, diarrhea, tonsillitis, cough and other diseases during lactation

During lactation, diseases can occur that are not associated with milk production or feeding the baby. The treatment of such pathologies can be complicated, since lactating women cannot be prescribed a number of drugs used in standard treatment regimens.

During lactation may develop:

Cystitis. It's infectious inflammatory disease Bladder, accompanied by frequent urination, as well as pulling pains in the lower abdomen. Treatment consists of drinking plenty of water, as well as the use of antibacterial drugs that can be excreted in breast milk. That is why it is recommended to interrupt breastfeeding for the period of treatment.

Thrush. it fungal disease, in which pathogenic fungi can affect a variety of parts of the body ( nails, mucous membranes, gastrointestinal tract and so on). Patients may experience severe pain or burning in the area of the mucous membranes of the genital organs, pain when urinating, pathological discharge from the vagina can be observed, and so on. Treatment consists in the use of antifungal drugs both locally and systemically. Since most of them are systemic use pass into breast milk, for the period of treatment should refrain from breastfeeding.
Sinusitis. This is an infectious and inflammatory lesion of the paranasal ( maxillary) sinuses, accompanied by inflammation and swelling of their mucous membranes and accumulation of pus in the sinuses themselves. Purulent sinusitis can be complicated by the spread of infection to the brain tissue, and therefore the treatment of the disease should be the use of potent antibiotics. Breastfeeding should be discontinued until full recovery female patients.
Constipation. For the treatment of constipation, laxatives can be used that do not enter the systemic circulation and are not passed to the baby along with breast milk ( duphalac, glycerin suppositories and so on). Breastfeeding should not be interrupted.
Diarrhea. To treat diarrhea, first of all, you need to identify its cause. If the cause is an infectious disease of the gastrointestinal tract, treatment should begin with washing the stomach and intestines. After that, the patient should be given drugs activated carbon which will also speed up the removal of toxins from the body. Use antidiarrheals ( from diarrhea) funds ( such as loperamide) during lactation is prohibited, as they can enter the body of the child along with breast milk.
Angina. This is an inflammatory disease of the palatine tonsils, caused by pyogenic bacteria. The main treatment for angina is the use of potent antibiotics, which requires a temporary cessation of breastfeeding.
Cough. Cough can develop with colds, flu and other infectious diseases respiratory tract. Lozenges can be used to fight infection in the upper respiratory tract and to relieve coughs ( septolete, pharyngosept and others), which have an antibacterial effect and are absolutely safe during lactation.

High temperature during lactation

Temperature during lactation can be a sign of damage to the mammary gland itself or other diseases. In any case, an increase in body temperature is a pathological sign indicating a problem in the body. The reason for the increase in temperature should be identified and eliminated as soon as possible, which will prevent further progression of the disease and the development of complications.

The reasons for the increase in temperature during lactation can be:

milk stasis;
mastitis ( breast inflammation);
infection genitourinary system;
upper respiratory tract infection;
cold;
food poisoning;
intestinal infection;
chronic diseases of the mother and so on.

If the body temperature does not exceed 38 degrees, you should not rush to knock it down, as this can reduce the body's defenses and contribute to the development of infection. If the temperature rises to 38 or more degrees, you can take antipyretics ( paracetamol, ibuprofen). This will temporarily reduce body temperature, but will not eliminate the cause of its occurrence. If elevated body temperature persists for 2 or more days ( or does not decrease after taking antipyretic drugs), it is recommended to consult a doctor. Before use, you should consult with a specialist.

From the point of view of benefits, mother's milk will always remain unrivaled. Even modern adapted milk mixtures are not able to replace such a valuable product. Often there are situations in which breastfeeding may not benefit the mother or newborn baby. In these situations, young mothers are forced to switch to artificial milk formulas.

To refuse breastfeeding must be present good reasons determined by the attending physician during an individual consultation.

Maternal contraindications

Unfortunately, not every woman can afford breastfeeding a newborn baby. Under certain circumstances, this procedure is strictly contraindicated. On the part of the mother's body, there are such contraindications to breastfeeding:

HIV infection and AIDS. The milk of an infected woman contains enough viruses that can cause infection in a newborn baby. positive test for HIV infection is an absolute contraindication for breastfeeding.
Tuberculosis of the lungs (open form). If a young mother has been diagnosed with an open form of tuberculosis, she is prescribed an extended course of antibiotic therapy, which is incompatible with breastfeeding. In addition, close contact with the baby will cause the child to become infected with the tuberculosis bacillus.
Infection with hepatitis C and B. These viruses are able to penetrate into breast milk in large quantities. If the child is given the hepatitis B vaccine in a timely manner, this helps to reduce the risk of transmission of the pathogen during breastfeeding. The risk of contracting hepatitis C through breast milk is lower than in the case of hepatitis B, but a newborn baby is not 100% insured. Absolute contraindication for natural feeding is the infection of the mother's body with hepatitis A, in which the risk of infection of the newborn is 85-90%.
Taking some medicinal medicines. The vast majority of drugs have the ability to penetrate into breast milk. Breastfeeding is strictly prohibited in the case of taking medications such as immunosuppressants, cytostatics, antiviral agents, radioisotopes, as well as anticoagulants and lithium preparations. The ban also applies to anthelmintic drugs and antibiotics (macrolides, fluoroquinolones and tetracyclines).
Tobacco smoking. Smoking and breastfeeding are incompatible, since if the components tobacco smoke into the child's body, the child becomes irritable, his appetite decreases and dependence on nicotine is formed. If a woman decides to breastfeed, then she is recommended to completely stop smoking for the entire period of lactation.

Rh incompatibility. If there is a Rhesus conflict between the body of the mother and the child, then breastfeeding is under strict prohibition. Otherwise, the babies develop a condition incompatible with life.
Severe chronic diseases of the liver, kidneys, respiratory and cardiovascular systems.
Mental disorders in a nursing woman.
Malignant neoplasms in the area of the mammary glands.
Severe infectious diseases (scarlet fever, erysipelas, diphtheria).

Child contraindications

On the part of a newborn child, there are much fewer contraindications to breastfeeding.

To the main contraindications child's body can be attributed:

Hereditary metabolic pathologies (phenylketonuria, galactosemia, maple syrup disease).
Birth ahead of schedule or low birth weight (less than 1 kg);
Severe condition at birth respiratory failure, shock, hypoglycemia, exsicosis);
Congenital pathologies of development (malformations of the cardiovascular system, diseases of the central nervous system, cleft palate, cleft lip).

Often, a young mother has situations in which it is recommended to temporarily suspend breastfeeding with its subsequent resumption. During this period, it is necessary to express milk in order to prevent lactation from stopping. Breastfeeding should be temporarily discontinued in the following situations:

With the appearance of herpetic or other rashes in the area of \u200b\u200bthe mammary glands. If the baby continues to consume mother's milk, he is at risk of contracting an infection.
With severe pain syndrome, when a young mother needs to take an analgesic drug that is incompatible with breastfeeding.
After the postponed surgical intervention when a woman will have a rehabilitation period.
If a woman has high blood pressure.

In addition, a woman should consult with her doctor about the possibility of breastfeeding in such cases:

When infected with influenza or sore throat. Ability to continue natural feeding depends on the severity of the pathological process. If a woman is prescribed antibacterial drugs, then many of them should not enter the child's body with milk.
With infectious diseases of the genitourinary system. This applies to infection with cytomegalovirus and toxoplasma. Under such conditions, it is not recommended to continue natural feeding.
With the development purulent mastitis. Majority medical professionals recommend not to stop breastfeeding with the development of lactostasis and mastitis. This improves the drainage of the mammary glands and reduces the intensity of the inflammatory process. If mastitis is accompanied purulent secretions from the nipple, then it is strictly forbidden to feed the baby with such milk. Lactation is recommended to be postponed until complete recovery, and in the meantime, the baby must be transferred to artificial milk formulas.
At severe complications labor activity at a woman. If the birth process was complicated by bleeding, then the woman should not put the baby to her breast for several days.

If it is necessary to temporarily or permanently interrupt lactation, it is recommended that a young mother discuss alternative ways feeding a newborn with the attending physician. The baby will be individually selected an adapted milk formula, which will replace mother's milk. By the way, you can find a list of all kinds of adapted mixtures, their characteristics and prices at the link.

Alcohol while breastfeeding

A sip of wine in honor of something ... Already regular consumption of alcohol during pregnancy can harm the baby. However, this also applies to the feeding period, since the baby drinks with you when you do it. He may even be "drunk" and even blissfully "nod". And it is still very difficult for him to break down alcohol. Therefore, the use of alcoholic beverages is strictly prohibited.

However, when the guests arrived, it is expected tasty food or the day turned out to be especially difficult - you can, rarely and on a special occasion, drink a glass of champagne, light wine or a glass of beer. It won't hurt, on the contrary, such a small sip will presumably relieve your tension and you will be able to re-engage with your child with more zeal. However, caution is needed with spicy and strong drinks! Not only will they harm your baby, but your milk supply will also decrease.

If you drink a glass of wine, it is better to do this during feeding or immediately after it - 30-60 minutes after that, the alcohol content in the mother's milk will rise to the same level as in her blood. Before next feeding it will at least fall again.

Sometimes a small sip to unload will help overcome difficulties with the flow of milk. But a glass should not become a habit!

Although alcohol during breastfeeding is not as strictly prohibited as during pregnancy, its consumption should be moderate. Alcohol passes into breast milk and can pass to the baby. Although many experts believe that a small amount of alcohol that enters a child in isolated cases, is unlikely to cause problems, in general drinking in large quantities should be avoided. It's also good if you try not to feed your baby for two hours after drinking alcohol. This will minimize the amount that the baby will receive with breast milk. Alcohol in breast milk can make the baby drowsy and make it difficult to move.

There is also evidence that children suck out much less breast milk from a mother who has consumed alcohol; perhaps this is due to the fact that alcohol has a blunting effect on the breast milk ejection reflex. (Here's another reason not to drink champagne while breastfeeding!)

Smoking while breastfeeding

In Germany, 30% of all pregnant women smoke, while in Japan only 2%. However, you probably already knew for a long time that smoking is bad for your baby, both before and after childbirth. However, few smokers manage to completely stop smoking during pregnancy and lactation. Those women who cannot quit smoking are usually hesitant to breastfeed. However, this solution is wrong! Feeding, even in this case, should be preferred to refusing it. Better try to control your bad habit.

Compromise:

Try to reduce your daily number of cigarettes to a maximum of five.

Smoke after you have fed - then the nicotine will already be partly destroyed by the next feeding time, and your child will “smoke” less with you.

No one should smoke in the presence of a child, as passive smoking is harmful to the bronchi.

Maybe you can stop smoking those last five cigarettes too?

Exposing your baby to secondhand smoke is always bad, but it's worst if you do it while you're breastfeeding. Breastfeeding mothers who smoke produce less milk than nonsmoking women. This may explain the fact that children whose mothers smoke are less likely to breastfeed. In addition, nicotine and other by-products Smoking gets into the mother's milk, and these are the substances that harm the baby.

It should also be added that in more than 50% of cases, smoking is associated with colic (a disease that occurs in newborns) and syndrome sudden death apparently healthy child. So there are many reasons to quit smoking. If you can't quit the habit, smoke after feeding your baby, not before.

You should also smoke outside or in another room to reduce the amount of smoke your child might inhale. (These tips also apply to mothers who bottle-feed babies: smoking is bad for all babies, whether breastfed or formula-fed. This goes for friends who smoke, and all family members. If they want to smoke, they should get out of the house. ) Do not also think that if you smoke, you should not breastfeed your baby. It is better to smoke and feed a baby than to completely deprive him of breast milk.

Can I drink coffee while breastfeeding?

Although it seems to you that you have never in your life needed a cup of strong coffee as much as now, when you are deprived of sufficient sleep, there are many reasons why you should give up this drink. Frequent use foods containing caffeine (coffee, tea, cola, cocoa, chocolate, and some prescription and over-the-counter drugs) cause anxiety, overactivity, and insomnia in some breastfed babies.

Herbs for breastfeeding

You should pay attention to the composition of herbal tea. Find out what types of tea can be consumed during the feeding period and which cannot. If you are not sure, check with your doctor. Several newborn babies have died because their mothers drank large amounts of herbal tea. It is also risky to give any herbal tea a small child, if you do not know for sure whether the product is harmful to him.

You should be very careful with these products. They may be natural, but most of them contain pharmacologically active substances that could harm your child. Few studies have been conducted on the effects of these products on a breastfed baby, so it is best to exercise caution unless you know for sure that the product is not contraindicated for breastfeeding mothers.

Contraindications to breastfeeding

Tuberculosis is a contraindication to breastfeeding

Mycobacterium tuberculosis is able to penetrate into mother's milk, at the same time, cases of infection of a child in this way (through milk) have not been recorded.

In active tuberculosis with the release of mycobacteria in environment(so-called. open forms) breastfeeding is contraindicated - high risk airborne infection.

With tuberculosis without isolation of mycobacteria (the so-called closed forms), breastfeeding is allowed.

Viral hepatitis- contraindications to breastfeeding

In hepatitis A, breastfeeding in the acute period is contraindicated.

With hepatitis B and C, breastfeeding is allowed, but through special silicone pads.

streptococcal infection- contraindication to breastfeeding

Breastfeeding is possible at normal body temperature in a nursing mother and provided that adequate antibiotic therapy.

HIV infection is a contraindication to breastfeeding

Breastfeeding is contraindicated.

Acute cytomegalovirus infection

The virus passes into milk. Nevertheless, healthy full-term babies can be fed.

Herpes simplex virus infections

Breastfeeding is allowed provided that there are no rashes directly on the mammary gland.

What infections are breastfeeding allowed for?

If the general condition of the mother allows, then, subject to standard hygiene rules, breastfeeding is advisable when:

acute respiratory viral infections;
acute intestinal infections;
infectious mononucleosis;
toxoplasmosis;
measles;
rubella;
chicken pox;
epidemic parotitis.

Postpartum lactational mastitis

Lactostasis - stagnation of milk in one or more areas of the mammary gland. lactation mastitis - inflammatory process in the mammary gland during lactation. There are no signs to clearly distinguish lactostasis and lactational mastitis from each other.

Lactostasis and lactational mastitis are actually two stages of the same process: lactational mastitis is a complication of lactostasis. In any case, feeding from a healthy breast should be continued in full. Feeding from the diseased breast should be continued if the pain is tolerable.

If you can express enough milk from a diseased breast to feed, then you can feed this milk, but most likely you are doing it wrong: if it is possible to endure pain during pumping, then you need to endure pain during feeding and apply the baby to the patient more often chest. If the pain is so unbearable that you can neither feed nor pump, it is direct reading to see a doctor. Numerous modern studies have proven that milk expressed during mastitis, even with an admixture of pus, is safe for feeding a child.

In some situations, breastfeeding is contraindicated. Let's find out which ones.

Maternal contraindications to breastfeeding

If you have had a double mastectomy or surgical reduction a breast where the nipples have been removed or the milk ducts have been severed, which will make breastfeeding impossible. Also, if you have the AIDS virus, you should not breastfeed. There is evidence that, in rare cases, the virus has been transmitted to the infant through mother's milk. A woman with active TB who has not been treated should also abstain from breastfeeding.

A mother who uses cocaine or other drugs should not breastfeed because substances that pass quickly into milk can cause serious illness or even death in the baby. Other substances that also require temporary suspension of breastfeeding include radioactive isotopes, antimetabolites, medications cancer chemotherapy and a small amount of other drugs.

Contraindications to breastfeeding by the child

If a child is diagnosed with galactosemia, they do not have liver enzymes and cannot digest lactose. Because in mother's milk there is a high content of lactose, then breastfeeding in this case is contraindicated. Continued feeding may cause a delay mental development. The child must be switched to a special formula such as Nutramigen. Some states include this disease in the test, which is carried out on all babies for some dangerous diseases.