Nursing mothers have many questions about the safety of various things during lactation. Following are some of the questions regarding health and medical issues we’ve answered over the past few years.
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Allergy shots do not affect breastfeeding.
Per Thomas Hale, PhD, “Allergy testing is carried out by the injection intradermally of small amounts of plant, animal, and other proteins. These substances due to their large molecular weights would not likely pass into human milk, nor would they be absorbed by the baby anyway. Thus allergy testing is not a contraindication to breastfeeding.”
There are conflicting opinions about donating blood while breastfeeding. The US Red Cross okays blood donation for nursing moms after 6 weeks postpartum. Donating blood causes a small loss of blood volume (and therefore a loss of fluid), so there is a theoretical possibility for a short-term temporary reduction in milk supply. Moms with vulnerable supplies may want to avoid donation. In general, women who are not pregnant, have good iron levels (that will be tested before donation), are not taking antibiotics, and are at least 100 pounds are good candidates for blood donation.
Cholesterol levels and breastfeeding
Mother’s cholesterol levels
High cholesterol levels during breastfeeding and anticholesterol drugs from Tom Hale’s Breastfeeding Pharmacology forum (information from Tom Hale, RPh, PhD and Gillian Arsenault, MD, IBCLC)
Obstet Gynecol 1993 Sep 82(3):451-5. The effect of lactation on glucose and lipid metabolism in women with recent gestational diabetes. Kjos SL, Henry O, Lee RM, Buchanan TA, Mishell DR.
Kallio MJ, Siimes MA, Perheentupa J, Salmenperä L, Miettinen TA. Serum cholesterol and lipoprotein concentrations in mothers during and after prolonged exclusive lactation. Metabolism. 1992 Dec;41(12):1327-30.
Qureshi IA, Xi XR, Limbu YR, Bin HY, Chen MI. Hyperlipidaemia during normal pregnancy, parturition and lactation. Ann Acad Med Singapore 1999 Mar 28(2):217-21.
Jensen RG, Ferris AM, Lammi-Keefe CJ. Cholesterol levels and the breast-feeding mom. JAMA. 1989 Oct 20;262(15):2092-3.
Erkkola R, Viikari J, Irjala K, Solakivi-Jaakkola T. One-year follow-up of lipoprotein metabolism after pregnancy. Biol Res Pregnancy Perinatol 1986 7(2):47-51.
Knopp RH, Bergelin RO, Wahl PW, Walden CE. Effects of pregnancy, postpartum lactation, and oral contraceptive use on the lipoprotein cholesterol/triglyceride ratio. Metabolism 1985 Oct 34(10):893-9.
Knopp RH, Walden CE, Wahl PW, Bergelin R, Chapman M, Irvine S, Albers JJ. Effect of postpartum lactation on lipoprotein lipids and apoproteins. J Clin Endocrinol Metab. 1985 Mar;60(3):542-7.
Child’s cholesterol levels
Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG. Infant Feeding and Blood Cholesterol: A Study in Adolescents and a Systematic Review. Pediatrics. 2002 Sep;110(3):597-608.
Owen CG, Whincup PH, et. al Does initial breastfeeding lead to lower blood cholesterol in adult life? American Journal of Clinical Nutrition August 2008 vol. 88 no. 2 305-314.
Dental work (x-rays, local anesthesia)
Breastfeeding is not contraindicated during fertility treatment. However, some of the drugs used for fertility treatment may significantly decrease milk supply. See the book Medications and Mothers’ Milk by Thomas Hale, PhD for more information.
Hyperbaric Oxygen Therapy
Per Daniel A. Nord (Coordinator, DAN Medical Services at Duke University Medical Center), this should not represent a problem for a nursing mom.
Laser Hair Removal
Laser hair removal does not affect breastfeeding.
Lice & scabies treatment
Permethrin (NIX, Elimite), a topical insecticide for lice & scabies, is considered safe for nursing moms. Per Thomas Hale, PhD (author of Medications and Mothers’ Milk), the amount transferred into milk is minimal and this drug is also used directly in children. Permethrin is preferred over Lindane, an older pesticide which is not recommended for use in newborns and young children.
Lice Treatment for Breastfeeding Moms by Tamara Carpenito
Litter Boxes, cleaning
According to LLL’s The Breastfeeding Answer Book, “To be on the safe side, the pregnant or nursing woman should not clean up after a cat, especially a cat under one year who goes outside. If you DO get toxoplasmosis, there is no evidence that it can be transmitted by BF, and mom will provide baby with antibodies – so breastfeeding can and should be continued.” Another option is to wear gloves when changing the litter box, and wash hands well afterward.
The CDC says “Perhaps, in the event that a nursing woman experiences cracked and bleeding nipples or breast inflammation within one to two weeks immediately following an acute Toxoplasmosis infection (when the organism is still circulating in her bloodstream), it is theoretically possible that she could transmit Toxoplasma gondii to the infant through her breast milk” but that “among healthy women, the possibility of breast milk transmission of Toxoplasmosis infection is not likely.”
Skin creams and lotions, in general, are not a problem for breastfeeding moms, though most are best kept away from the nipple area (so that baby does not swallow it). When it comes to topical medicines, virtually nothing passes through the skin to the bloodstream unless it is specifically formulated to do so (such as the nicotine patches).
This does not pose a problem for nursing moms.