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Breastfeeding On Drugs? (After a Cesarean)

By Rebecca Odes |

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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About Rebecca Odes


Rebecca Odes

Rebecca Odes is a writer, artist and mother. She was inspired to write her blog, From The Hips, during her first pregnancy when she discovered every pregnancy book she came across made her feel anxious or irritated. She lives in New York City with her husband and two children.

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0 thoughts on “Breastfeeding On Drugs? (After a Cesarean)

  1. Kelly says:

    It could also be that there’s a ‘safe’ dose for medications during lactation (from studies) but no ‘safe’ dose has been established for alcohol. While most women could fed after a beer it’s easier and more straightforward to just say ‘avoid it’ when there’s no health benefit to having that beer.

  2. Maryellen says:

    I think the “dont ask if you dont want the answer” hush hush brush it under the rug is being applied here. It is worrying that everything is put in such a way that you wouldnt want to question it, as it seems ok, risk vs benefit etc. There have been studies in the past showing the effects of the drugs used through labor on breastfeeding (not in terms of harm, but in terms of ability to). It is a risk vs benefit scenario for casearean birth unfortunately, but nothing makes it particularly safe in any quantity for babies in my mind.

  3. Liz Brooks says:

    *Any* meds in labor — whether topical, intravenous, epidural, or associated with surgical birth (C-section) will cross over to the fetus, via the placenta, which means baby gets it at the same strength as mom. These drugs can *all* reduce the baby’s inherent skill and ability to breastfeed after birth. Can the baby and mother overcome these problems? Yes. Avoiding them altogetehr is a lot easier on everyone.

    Lactation provides a huge “filter.” Everything mom ingests (drinks, foods, meds) cross into her bloodstream … and it is from the bloodstream that milk is made. And — the amount in the milk is a fraction of what it is in Mom’s bloodstream. That is why pain meds after birth are not considred a risk for the baby. The amount the baby gets is much, much lower than what mom feels.

    Alcohol, however, is one of the very few substances that crosses over to the breastmilk in roughly the same “oomph” level as mom senses. The good news is that alohcol metabolizes very quickly. So, if you have a beer just before or just after you nurse your baby, it is unlikely to have found its way to the breastmilk. Bear in mind — NO parent … not lactating mom; not non-lactating partner … is supposed to be getting drunk. And that has nothing to do with breastfeeding, and verything to do with parenting.

    An IBCLC has assist ANY mother in determining the impact of meds (incl. labor meds) on lactation.

  4. AQ says:

    I had a nurse who convinced me to only take a half-dose of painkillers the day after my C-section because I was nursing. Then she didn’t come back to give me my next dose, probably because she knew I would have clawed her eyes out. (does that sound harsh?) I was in too much pain to nurse at that point anyway. For me, there was no comparison between that post-surgery pain and regular labor.

  5. Lucky says:

    While I agree that it’s absurd to think that one beer would be harmful to a breastfed infant, can you imagine if women were expected for forgo pain killers on top of everything else we are expected to do/not do this week or that week because it might have a slight effect on our children.

  6. Siobhan says:

    Since when is it controversial to have a drink (notice the singular) and breastfeed? I’ve not heard of that and I find it absurd. Even the American Academy of Pediatrics says it’s ok, “if you’re sober enough to drive, you’re sober enough to breastfeed.”

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