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Breastfeeding On Drugs? (After a Cesarean)

My sister and I were talking the other day about breastfeeding after her c section.  She was anticipating her doped up postpartum state, and wondering whether breastfeeding with all those drugs in her system could be a problem for the baby. I assured her that all recommendations indicated that there was no risk from nursing through the postpartum painkiller phase and in fact most experts recommend you take them before a breastfeeding session rather than wait it out and risk being in severe pain while nursing.

But why, she wondered, is it okay to breastfeed with massive doses of painkillers coursing through your system when women are discouraged from nursing after a beer?

Why the double standard?

I’ve always found it interesting that there is so little controversy about this considering how much controversy there is about breastfeeding on drugs in general.
But across the board, women are told not to worry about the effects of pain medication on their babies from postpartum breastfeeding after surgery. I remember how adamantly this was stressed when we were researching From The Hips.

Here are some of the reasons this might be the case:

  • A Cesarean is major surgery. Pain relief is required for recovery.
  • The pain medications used are considered “compatible with breastfeeding”.
  • The quantity ingested by newborns is tiny, so the quantity of drugs is not considered signficant.
  • Colostrum is immunologically valuable enough to overshadow any impact of the drugs in it.
  • The first few days of breastfeeding are so important for establishing a long term breastfeeding relationship that it wouldn’t make sense to discourage nursing at this crucial time.
  • Pain increases stress and cortisol, which can be bad for milk production, and, it is being discovered, could be a harmful “drug” in itself.
  • Most babies born in the hospital have drugs in their systems anyway, from epidural or other drugs used during birth. So this is kind of a given in the medical model.

Basically, it’s a question of risk/benefit ratio. There’s no reason to think that there’s any risk to babies from breastfeeding while on painkillers after a C section. But there is reason to think that not using painkillers could interfere with breastfeeding, and that not breastfeeding would be detrimental to the long term breastfeeding scenario (and keep your baby from getting valuable postpartum antibodies and nutrients from the colostrum.)

Maybe someday someone will do a study and find out something different. But at this point it seems the collective concept is to assume it’s the best course until proven otherwise. And for the benefit of all the moms who have C sections, I kind of hope it stays that way.

photo: Aurimas Mikalauskas/flickr

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