Breastfeeding Restrictions & Pregnancy Pains

Q: I am currently pregnant and planning on breastfeeding. My question isn’t about pregnancy or childbirth, but rather a post-partum question about breastfeeding. Are there similar restrictions on food intake and over the counter drugs while breastfeeding, as compared to during pregnancy?

A:

There are similar restrictions on food intake and over the counter drugs (medications) while breastfeeding as compared to during pregnancy. When food intake is concerned and assuming your diet is well balanced during pregnancy it is best to not alter this too much after you have your baby. However, when breastfeeding it is important to ensure you are getting adequate calcium, protein and calorie intake as these needs do increase with breastfeeding. For more detail on breastfeeding and nutrition please see previous post on nutrition in Ask a Midwife.

Although usually not harmful to your baby, certain foods and vitamins passing through breastmilk have been known to cause digestive irritation and some people have referred to this as “colic”. Colic is an overused but not a well defined term and refers to episodes of inconsolable crying in newborns.

Although your question is not about pregnancy so much it is important to be aware there are some medications that are safe during breastfeeding but not during pregnancy. One may assume that if it is safe during breastfeeding it may also be safe during pregnancy. As an example Ibuprofen in the third trimester of pregnancy (after 28 wks gestation) should be avoided if possible as it has been associated with premature closure of the ductus arteriosus (one of the heart valves) in newborns, however it is safe and commonly prescribed during the postpartum period to help women with strong “afterpains” of the uterus.

Whenever you are considering taking any over the counter medication it is recommended that you check in with the pharmacist or your health care provider and inform them you are pregnant and or breastfeeding. If you are in the first trimester of your pregnancy and you have been taking prescription medication, it is really important to inform your family doctor that you are now pregnant. Your prescription may need to be discontinued or altered. Likewise, depending on the type of medication taken during breastfeeding it also may need to be altered and timed according to breastfeeding schedule to ensure less exposure in breast milk. Your local pharmacist is valuable resource in your community that you can consult with. In addition please find below informative links you may find helpful:

Motherisk
Drugs in Pregnancy and Breastfeeding
Pregnancy-Related Issues in the Management of Addictions

 

Q: I’m in my second pregnancy and have a six year old. It might sound strange, but I barely remember what pregnancy feels like, and this one seems a lot different. I am in my third month having some pain in my left kidney and pulling twinging feeling in the muscles of my lower abdomen. I was wandering if this is common and what I can do to support my kidneys to keep them healthy during this pregnancy?

A:

These are great questions to ask, and address a few interesting and common pregnancy concerns that many women have. Like each human being, each pregnancy can be very different from the last. Women may carry each baby very differently, experience the early symptoms of pregnancy in a variety of ways, and each baby may have a completely different pattern of movement.

To address the first topic, I can’t specifically answer for you what it may be, but I can say that whenever you have pain or tenderness in your kidneys, it is important to follow this up with your midwife, or physician. It may actually be something simple like muscle tension from the growing weight of the uterus, or it may be a symptom of a kidney infection (also known as pyelonephritis). Symptoms of kidney infections may also include-but are not limited to-frequent and painful urination, fever, chills, or a general feeling of being unwell. Kidney infections can be easily treated with antibiotics and it is important to do so, because in pregnancy they have been associated with some serious complications such as sepsis and premature labour.

The best way to support your kidneys in pregnancy is to make sure that you drink an adequate amount of clear fluids. Suggestions for this would include plenty of water. If you know that you are pre-disposed to having urinary tract infections or kidney infections, you could drink diluted and unsweetened cranberry juice preventatively.

In regards to the lower abdominal “twinges”, again it is hard to specifically say what it is that you are experiencing. The body goes through many changes in pregnancy! What you are describing is another common sensation that many women feel. It is usually related to the growing uterus and the stretching of the round ligaments to accommodate this growth. I included a diagram so you can see how the ligament attaches to the uterus and the pelvis. It attaches to both sides of the uterus and pelvis, and women often feel a pulling sensation on one or both sides of their lower abdomen. A crampy sensation, similar to menstrual cramps, can also be normal and is related to the growing uterus.

Those are the most common causes of what you have described here, and many women experience these types of discomforts. However they are not always “normal” findings and so I would recommend you discuss them with your care provider if they are accompanied by any of the following symptoms:

  • symptoms of urinary tract infection or kidney infection (as listed above)
  • sharp pain
  • if your abdomen is tender to the touch
  • fever, chills, nausea or vomiting, and diarrhoea
  • vaginal bleeding

Great questions. I hope this information helps.

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