Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
A lot of drugs (virtually all of them, in fact) come with labels warning pregnant and nursing mothers to consult their doctor before taking.
Most health care providers consult the PDR (Physicians Desk Reference), which is an anthology of medication inserts, which are regulated by the FDA. This information is incomplete, specifically neglecting studies done after a drug was approved, unless the FDA required a change in the insert as a result. Some health care providers may consult the Merck Manual, which is published by a particular pharmaceutical conglomerate. Needless to say, this is not the most objective source of information.
Very, very few drugs have been studies in pregnant or nursing women. There are obvious ethical concerns (which no one seems to worried much about when prescribing them without the information a large, well-designed and executed study would give health care providers). Low-dose aspirin is not only safe, but may be beneficial for pregnant women at risk of preeclampsia; it is on a very short list of drugs which have been studies extensively in pregnant women and found to be very safe -- yet many advice sites steer women away from aspirin, towards other analgesics (NSAIDs) that have been shown to be less safe during pregnancy.
Sweden, and a few other countries, maintain a registry of all women who become pregnant, everything they are taking or exposed to, and their perinatal outcomes. In 2001, a possible association between Claritin (loratadine) and infant hypospadias appeared. The Swedes continued to track it, and other independent studies were done, which failed to find an association. This illustrates some of the difficulties of finding out what drugs are safe and which are not safe to take while pregnant.
There has been a great deal of back-and-forth on antidepressant use by pregnant women. For a long time, pregnancy was viewed by the (predominantly male, historically) medical community as a period during which women tended not to become depressed, and during which depression might naturally go into remission. This has recently been shown not to be true (surprise -- wrench someone's life around, subject her to a bunch of conflicting and confusing advice and a lot of medical procedures, made her gain a bunch of weight in a culture which thinks fat is worse than major disability, put her job at risk, and then isolate her. Do you think she might get depressed? Maybe?). Perhaps as many as 1% of pregnant women in the U.S. take antidepressants, which is a significant market for pharmaceutical companies. Virtually all experts doing studies on the safety of antidepressants have some financial relationship to the pharmaceutical companies. We do know that SSRIs taken after the 20th week of pregnancy incrase the risk of having a baby with PPHN (persistant pulmonary hypertension of the newborn), which has a 10-20% mortality rate afater treatment. Stopping antidepressants abruptly can be quite dangerous. It is a pity we do not have a better understanding of non-drug treatment of depression. Certainly, supportive, loving relationships, good communication with loved ones, regular, moderate exercise, adequate, nutritious and enjoyable food, restful sleep, enough leisure time and rewarding work have all been showed to alleviate symptoms of depression. Our culture conspicuously does not value these things, and our medical community thinks pills first, talk therapy second, and objective circumstances of one's life never.
Other Useless Advice During Pregnancy
A lot of doctors advocate weaning when prescribing anything at all to nursing mothers, to avoid any risk. They are not considering the huge risk of giving formula to a baby, which is almost always much higher than the risk associated with the medication.
If you have to take a medication and a health care provider tells you you cannot safely nurse while taking this medication or that you should wean while on this medication or something along those lines do not believe them. I have yet to meet anyone who was told this where it was actually true. It occasionally is true. Radiation therapy is basically not safe for breastfeeding. Chemotherapy is also not safe for breastfeeding. There are a very few other medications. Everything else is either safe, or probably safe, but we do not know for sure yet. The definitive book on the subject is by Thomas Hale. As always, google is your friend. It found me this, if you really like allopathy. As always, if you want to wean, you are the adult here and you are the one who has to live your life. Do what you want and need to do. But please do not wean because some idiot doctor tells you to wean.
You might be told to wean inappropriately for medication taken in these situations:
If a doctor, health care provider or other information source tells you some drug (for example, pseudephedrine, and estrogen birth control) might reduce your milk supply, they probably do know what they are talking about and you should listen to them. You might want to get a copy of Hale's book and look up everything you take regularly (including over-the-counter and supplements).
Other Unhelpful Medical Advice While Nursing
Copyright 2006 by Rebecca Allen.
Created February 1, 2006 Updated July 11, 2006