As a nurse practitioner, I often see new mothers facing the challenging task of discussing medications while breastfeeding with their healthcare providers. It's crucial for moms to feel empowered and equipped to engage in these conversations, understanding both their needs and the perspectives of their providers. Here are some practical tips to help you navigate these discussions confidently and collaboratively.
Understanding the Role of Your Prescriber
Healthcare providers serve as gatekeepers for medications, prioritizing your safety, especially during breastfeeding. Their main focus is prescribing treatments that are safe for both you and your baby, which often leads to a cautious approach as they weigh the benefits of medication against potential risks to lactation and infant health—particularly if they aren’t specialized in infant care. When treating postpartum and breastfeeding patients, many providers tend to choose what they believe to be the safest options, adhering closely to the principle of "do no harm." However, breastfeeding has known health benefits for mom and baby that should also not be discounted during this evaluation. Some medications may be compatible with breastfeeding, or the risks may be acceptable to retain the benefits of breastfeeding, but reaching that conclusion often requires a thorough understanding of the latest research. In these nuanced situations, differing opinions among doctors, lactation consultants, and pharmacists are common. When faced with conflicting advice, asking providers how they arrived at their recommendations can help clarify their reasoning and ensure you make the most informed decisions about your care.
Using Tools like MommyMeds
If you know which medications you’ll be talking about, take some time to educate yourself about them before your appointment. Understand their uses, benefits, and potential risks during breastfeeding. This knowledge will not only help you ask more informed questions but will also enable you to engage in a more meaningful discussion with your provider. Tools like the MommyMeds app can be incredibly useful for bridging the gap between your needs and your prescriber's cautious approach. This app provides evidence-based information on the safety of various medications during breastfeeding written by experts in lactation pharmacology: Drs. Krutsch and Hale. By using MommyMeds, you can gather credible information and prepare for your appointment. This preparation not only boosts your confidence but also helps you present your case in a well-informed manner, facilitating a more productive dialogue with your healthcare provider. For your provider, we also have apps written in more technical language that allow them to easily compare the lactation safety of similar medications (see the InfantRisk HCP app).
Did you know: Both MommyMeds and the InfantRisk HCP app help fund the research at the InfantRisk Center? We are so thankful for the support so that we can continue supporting YOU!
When the information alone doesn’t help you feel confident, the InfantRisk Center is a free call center and online forums that can be accessed for more specific questions. The call center can be contacted at 1-806-352-2519 Monday through Friday, 8AM to 3PM CST.
Preparing Questions for your Provider
Prepare a list of questions beforehand to ensure you cover all aspects of your concern during the consultation. Here are some questions you might consider:
- What are the benefits of this medication for my condition?
- Are there any risks associated with this medication while I am breastfeeding?
- Are there alternative treatments that might be safer during breastfeeding?
- How does this medication affect my baby and my breast milk?
- How have you considered the benefits of breastfeeding for me and my child in your recommendation?
- What can I watch for in my breastfed child if I breastfeed while on this medication?
- Would the risk/benefit balance shift if my baby was older/younger/more fragile…?
Approaching with Curiosity
When discussing medication options, it's beneficial to approach your doctor with curiosity rather than confrontation. Asking questions like, "Can you walk me through how you came to that conclusion?" opens a dialogue that allows for mutual learning and understanding. This approach shows respect for the provider’s expertise while also expressing your desire to understand the rationale behind their recommendations and collaborate with them in your healthcare.
Be Open to Alternatives
Be open to discussing alternatives. Sometimes, a different medication or a non-pharmaceutical treatment may be available. Discussing alternatives can provide options that you and your prescriber feel comfortable with, ensuring the safety and health of both you and your baby.
Conclusion
Remember, the goal of any medical consultation is to ensure the best outcomes for you and your child. Both you and your provider have the same end goal: to help you reach your health goal in a safe manner without negatively impacting you or your baby. By coming prepared, using tools like MommyMeds, and approaching the conversation with curiosity and openness, you can help your healthcare provider understand your perspective and work together to find the best possible solution. Empower yourself with knowledge and confidence, and remember that you have the right to question and understand the healthcare decisions that affect you and your baby.
Find a doctor: https://www.bfmed.org/find-a-physician#/
Nichole Campbell, MSN, APRN, NP-C
Kaytlin Krutsch, PhD, PharmD, MBA, BCPS
