Tuesday’s Tips: Helpful Counseling Tips for Medications, Herbs & Galactagogues from Dr. Frank Nice


As a lactation specialist or one aspiring-to-be, you may find yourself getting asked questions regarding the safety of prescription and over-the-counter (OTC) drugs by your breastfeeding clients. Or maybe it’s not medications, but the safety of herbs or the use of Galactagogues.


As lactation professionals (and those aspiring to be), it’s essential we stay within the scope of our training and certification. Diagnosing and prescribing prescription and OTC medications, herbs and galactagogues are outside the scope of practice for IBCLCs (and other lactation specialists) – unless of course, you’re also a licensed health care provider who has the ability to diagnose and prescribe medication. What we CAN do as lactation specialists is to counsel our breastfeeding clients and provide them with evidence-based resources so that they can make an informed decision that is best for themselves and their family.


In the Middle East where I used to live and practice, it was not common practice to question your physician’s recommendations, ask questions, or even to begin an open dialogue about potential alternatives, risks and benefits, etc. To question your doctor was a big no-no and it was something that just wasn’t done.

But because my client’s (and their infant’s) health and well-being come first, I encouraged every single one to bring every single evidence-based resources to their health care provider – to ask questions, demand answers and to begin an open dialogue. Yes, I admit I probably committed a few cultural faux pas, but it was worth it.

I found this not only enabled those I worked with to make informed decisions that worked best for them and their families, but it EMPOWERED them as well. The cherry on top was that it also educated health care professionals on lactation issues, which was often desperately lacking. Due to this approach, I was able to establish working relationships with local health care providers and to network. It was a win-win.


Dr. Frank Nice, RPh, DPA, CPHP

You may be wondering where to start when counseling your breastfeeding families on prescription and OTC drugs, herbs and galactagogues. How do you go about it? What approach would you take? What questions should you be asking and answering? Well, thanks for Dr. Frank Nice over at Nice Breastfeeding, he’s got all of this covered.

He has shared a wealth of information in order to help you help your breastfeeding families. Best of all, it’s all FREE and immediately accessble – just click here for practical, relevant counseling tips that you can begin applying with soon as the situation arises.

This link is divided into 3 sections: 1) About Mom, 2) About Baby, 3) Useful PDFs (on several topics including but not limited to Domperidone, Galactalogues and Herbs, and Recreational Drugs). These are free, downloadable and are perfect resources to share with your breastfeeding families.

And don’t forget to encourage your clients to share these handouts with their health care providers – not only will this create an open dialogue of how to best approach their situation and meet their needs, but it will also help to educate health care providers as well.

There is also a helpful ‘Patient Resources’ section with  Useful Links that you can share with your expecting and breastfeeding clients. Again, these are free!


Dr. Frank Nice, RPh, DPA, CPHP,  founder of Nice Breastfeeding, has over 40+ experience specializing in medications and  breastfeeding. He has also authored 2 books: Nonprescription Drugs for the Breastfeeding Mother, 2nd Edition (2011) and The Galactogogue Recipe Book (2017).


Advertisements

Free Drug Safety & Lactation Resource List

Free Drug Safety & Lactation Resource List


Author’s Note:  This post used to be a static page. I turned it into a blog post to make it more accessible and easier to search. Providing lactation support is hard enough, it’s my goal to make whatever I can easier and simplified for lactation specialists and those aspiring-to-be.


Do your clients ever call you wondering if a particular medication is compatible with breastfeeding? Many times nursing mothers are told to “pump and dump” or wean by their physicians when in fact, it’s unnecessary. Other times, it’s assumed if a medication is over-the-counter or an herb, it’s completely safe. This is not always the case.


Check below for the most widely used evidence-based resources in order to evaluate drug risk and safety during lactation. This list is arranged by alphabetical order and is by no means exhaustive, so if you’ve found another database or resource helpful, let me know so I can add it.


Questions for lactation professionals and nursing mothers to consider when evaluating risk levels of drugs, herbs, chemicals, etc. during lactation:

1) Will the drug, etc. affect my baby?
2) Will the drug, etc. affect lactation?
3) What are the risks of weaning?
4) What are the options?

For tips on how to counsel your breastfeeding clients on medications, galactagogues and herbs, see these tips by Dr. Frank J. Nice, RPh, DPA, CPHP.


Electronic Databases 


Breastfeeding Network –  Provides FREE Fact Sheets on a wide array of drugs, medical procedures and health conditions and compatibility with breastfeeding available here. These are great to share with your clients (and to encourage them to print them out and discuss safety concerns or potential alternatives with their health care provider). Also provides a detailed description of an ‘Introduction to the Safety of Drugs Passing Through Breastmilk’ here. For common FAQs concerning breastfeeding and generic medications, see here. Also contains general ‘Information on Breastfeeding’here, ‘Thinking about Breastfeeding’ here, ‘Breastfeeding and Perinatal Mental Health’ here and common ‘Questions about your Baby’here.

TIP: when using drug search databases: Since drug names can differ by country and even more so if it’s a generic vs. name brand drug, if the drug you are searching does not show up in the database search engine, then google that particular drug for the active ingredient and search by that instead.

e-lactancia – Compiled by pediatricians affiliated with APILAM. Uses risk levels 0 (no risk) -3 (very high risk). Covers “medical prescriptions, phytotherapy (plants), homeopathy and other alternative products, cosmetic and medical procedures, contaminants, maternal and infant diseases and more.” For common FAQs concerning lactation and medications, see here. Very easy to use and understand. A great resource to share with families so they can look up their own medications. Available in English and Spanish.

Infant Risk Center – Researched and compiled by Dr. Thomas Hale, PhD and author of the renowned and widely used medical lactation risk and reference guide, ‘Hale’s Medications and Mothers’ Milk.’ This reference guide is updated every 2 years, with the most recent edition published in 2017 and a new edition coming out in 2019). This resource uses lactation risk categories 1 (safest) – 5 (contraindicated). It covers prescription medications, chemicals, herbals, vitamins and radioisotopes/radiocontrast agents. This reference guide is also affiliated with the Infant Risk Center at Texas Tech University Health Sciences Center. A detailed description of ‘Drug Entry Into Human Milk’ is available here. If you have a question regarding a particular drug, you can call a free helpline at (806) 352 – 2519.

Medications & Mother’s Milk is an electronic database also established by Dr. Hale. Annual subscriptions are available at varied prices for individuals and groups/institutions. Mobile apps are also available for both androids and iOS – one is for healthcare professionals ($9.99) and the other is a simplified version for parents ($3.99). You can view options here.

LactMed – Sponsored by the National Institute for Health (NIH)’s US National Library of Medicine TOXNET Toxicology Data Network. It provides peer-reviewed, fully referenced, evidence-based resources. Users can look up lactation risk of both drugs and chemicals. This site is highly medicalized and may be too versed in “medical speak” for the average consumer to fully understand. LactMed also offers a mobile free app for both android and iOS.

MotherRisk – Sponsored by The Hospital for Sick Children in Toronto. It provides evidence-based information about the compatibility of prescription and over-the-counter medications, herbal products, chemicals, radiation, chronic diseases, infections, occupational, environmental, and other exposures during pregnancy and lactation. Also covers general FAQs about medications and lactation. Various brochures are available here. Offers a FREE MotherRisk Hotline: 1-877-439-2744, which is open Monday – Friday 9 a.m. to 12pm and 1 to 5 p.m. Eastern Standard Time.


Additional Drug Safety & Lactation Resources


Breastfeeding &  Human Lactation Study Center (which is a part of the Division of Neonatology at University of Rochester Medical Center’s Golisano Children’s Hospital) under the direction of Ruth A. Lawrence, M.D. Healthcare professionals can call (585) 275-0088 at no cost for information on drug risk and compatibility and to consult on difficult breastfeeding issues. Note: This hotline is for healthcare professionals ONLY, not for parents or your breastfeeding clients. For more information, see here. See here for a breastfeeding site geared specifically toward your breastfeeding clients and families.

Cindy Curtis, RNC, IBCLC, CCE, CD of Breastfeeding Online has compiled a comprehensive and beautifully organized list of lactation risk and compatibility with direct links to articles on breastfeeding and alcohol, herbals, epidurals, antidepressants, social drugs, cigarettes, prescription and non-prescription drugs and more. This is an accessible and quite handy resource to share with your breastfeeding clients or lactation specialists-in-training.

Frank J. Nice, RPH, DPA, CPHP of Nice Breastfeeding has written several books on medications and compatibility with breastfeeding: ‘Nonprescription Drugs for the Breastfeeding Mother’ (2017) here. ‘Recreational Drugs and Drugs Used to Treat Addicted Mothers: Impact on Pregnancy and Breastfeeding’ (2016) available here. ‘The Galactagogue Recipe Book’ (2017) which discusses dosage, uses, and cautions of galactogogues here. There are free downloadable pdfs on a wide array of lactation and drug risk categories including herbs and galactagogues, recreational drug use and Domperidone are available hereFree patient resources with helpful links are available here. You can find information for healthcare providers on how to counsel breastfeeding mothers who have drug-related questions here.

International Breastfeeding Centre established by Dr. Jack Newman, MD, IBCLC provides a general overview of maternal medications and breastfeeding in a Q&A blog post format, addressing general FAQs, whether or not to continue breastfeeding, how drugs get into breast milk and lactation compatibility with specific medications here. If you have a question about a particular drug’s compatibility with breastfeeding (or you’re dealing with a difficult breastfeeding case in general and would like some guidance and feedback), Dr. Newman answers emails from Lactation Specialists at no charge here. Information sheets on a wide array of lactation topics are available here, many of which are translated into different languages here.

Kelly Bonyata, BS, IBCLC of Kellymom has compiled lists of lactation risk databases in English and other languages, common FAQs on specific drugs, treatments and medical procedures, lactation risk resources and a detailed list of reference links here.This is an accessible, easy to understand resource to share with your breastfeeding clients.

La Leche League International (LLLI) has also published some articles and FAQ fact sheets on medications and breastfeeding. It also has a comprehensive resource of hyperlinked articles addressing breastfeeding with maternal illness, conditions, diseases and  if medications/treatments are compatible. LLLI’s site, including it’s articles (typically written  for mothers and parents by mothers (who are also breastfeeding counselors), are fantastic reat resources to share with nursing mothers and families as they are easily accessible, usually short and sweet, and written for an audience without a medical background. Just click on the title(s) below:

Wendy Jones, BSc, MSc, PhD, MRPharmS of Breastfeeding and Medication.This comprehensive site includes free downloadable Fact Sheets, evidence-based useful links on medication and breastfeeding, E-Learning Packages/Training Packs, aimed at GPs (latest cost was £40.00), which can be purchased here. She has also authored the books, “Breastfeeding and Medication.” (2018) and “Why Mothers’ Medication Matters” (2017).


Herbs & Breastfeeding


Kelly Bonyata, BS, IBCLC of kellymom.com has created a simple, accessible resource list of specific herbals and natural treatment and compatibility with lactation here. For information on marijuana and breastfeeding, see here. These are both fantastic, easy to read and understand resources to share with your breastfeeding clients.

Sheila Humphrey, BSc, RN, IBCLC has written the ‘The Nursing Mother’s Herbal’ (2003) available here, which discusses the effects of a wide array of herbs, dietary supplements and natural remedies on lactation and lactation-related maladies such as mastitis, plugged ducts, thrush and more. Her book is organized into Herb Safety Categories A (no contraindications) – E (Avoid. Toxic plant with no justifiable medical use). See here for a more thorough description of the Herb Safety Categories and see here for a review of her book from LLLI.


This list is by no means exhaustive. If you have a evidence-based resource on drug safety and lactation that you recommend and it’s not included in the list, then please, send me a message with a description and relevant info so that I can include it. Thanks a bunch, xx

Freebie Friday: FREE Podcast on “Marijuana & Breastfeeding”


Yup, it’s the end of the week already. That means it’s time for FREEBIE FRIDAY! This week’s freebie is a FREE Podcast on “Marijuana and Breastfeeding”
by Anne Eglash MD, IBCLC and Karen Bodnar MD, IBCLC.


From the Institute for the Advancement of Breastfeeding & Lactation Education (IABLE) website:

“Join us to learn about the 2018 American Academy of Pediatrics statement on marijuana during pregnancy and breastfeeding. Dr. Bodnar summarizes the major points in the AAP’s 2018 statement on marijuana during pregnancy and breastfeeding. Learn the latest recommendations on how to counsel families regarding perinatal marijuana use!”

It was originally recorded in September 2018, but don’t worry, it’s still available as a podcast for free. Just click here to listen to it.

Quick tip: When you click on the link to view the Podcast, check out the “Programs” header on the left side of the site. You’ll find lots more FREE lactation resources including Podcasts, Videos, Breastfeeding Handouts, Breastfeeding Education for Healthcare Providers, Clinical
Questions for the Week, Conferences and more.

Happy listening (and learning). Oh, Happy Friday too!


Do you have an idea for FREEBIE FRIDAY? Don’t be shy! Share it with Galactablog – you will be given full credit. If you’re a company, private practice, NGO, etc. and have a FREE opportunity or item to offer to Galactablog readers, let us know. As long as you are WHO Code Compliant, you’ll be given full consideration. You can contact us here or email: galactablog@gmail.com. 

FREEBIE FRIDAY: FREE Resource Guide: “10 Ways to Inspire Families to Say ‘I love My IBCLC'” by Annie Frisbie

 

Annie Frisbie, IBCLC & Author

It’s that time again! Annie Frisbie, IBCLC and author of Paperless Private Practice for the IBCLC and IBCLC Private Practice: From Start to Strong is generously offering a FREE resource guide illustrating 10 ways you can be the BEST lactation professional you can be.

Whether you’re in private practice, work in a hospital or clinic, the public health arena or serve as a breastfeeding supporter – this advice is essential and relevant. So hurry up and check it out. Your work/life balance and breastfeeding families you serve will thank you. You download it here.

Feel free to share your favorite tip in the comments. I’d love to hear your opinion. Thanks again Annie for yet another Freebie!

Wanted to share with everyone that Annie also created an affiliated private Facebook group that you can join, ask questions and see what other Lactation Professionals are up to. And yup, totally free. You can join here. Thanks a bunch Annie!

If you’re interested in seeing what else Annie is up to, find her at:
Facebook: https://www.facebook.com/paperlessibclc/

FREEBIE FRIDAY: “How to Be a HIPAA-Compliant IBCLC” Free Guide From Annie Frisbie, IBCLC

 

 

Are you ready for some more FREEBIES? If so, then you’re just in time. Annie Frisbie, IBCLC and author of the best selling Paperless Private Practice for the IBCLC and newly released IBCLC Private Practice: From Start to Strong is graciously offering a FREE resource on “How to Be a HIPAA-Compliant IBCLC.” Just click here and register. This will give you instant access to the FREE guide. Easy peasy.

And better yet, Annie also created an affiliated private Facebook group that you can join, ask questions and see what other Lactation Professionals are up to. You can join here. Thanks a bunch Annie!

If you’re interested in seeing what else Annie is up to, find her at:
Facebook: https://www.facebook.com/paperlessibclc/

Do you have an idea for FREEBIE FRIDAY? Don’t be shy! Please do share – I promise to give you full credit. If you’re a company, private practice, NGO, etc. and have a FREE opportunity or item to offer to Galactablog readers, please drop me a line. As long as you are WHO Code Compliant, you’ll be given full consideration. You can contact me here or email me at: galactablog@gmail.com. I look forward to hearing from you.

FREEBIE FRIDAY: Free Patient Handouts, Posters & Educator Flip Charts (and More!) from Ready, Set, Baby!

It’s FREEBIE FRIDAY again! Well, actually it’s Saturday, but I figured better late than never, so here it goes. The Carolina Global Breastfeeding Institute’s Ready, Set, Baby! program has lots of great resources for lactation professionals in English and Spanish (with Arabic coming soon). Best of all, it’s all FREE – you just print it out.

Click here for English resources

Click here for Spanish resources – and make sure to check back, Arabic is coming soon.

Do you have an idea or freebie that you would like featured on Galactablog’s FREEBIE FRIDAY series? If so, don’t be shy! Please do share. You can contact me here. I look forward to hearing from you.

“Tips from the Trenches” by Dr. Becky Saenz (free handouts)

“Tips from the Trenches”

by Dr. Becky Saenz, MD, FABM, IBCLC

circle

Through the Emerald Coast Alliance for Breastfeeding Support, Dr. Becky Saenz, MD, FABM, IBCLC has developed “Tips from the Trenches.” First off, this is an awesomely amazing name. Love it! Even better, she’s offering her “tips” for free! Yup, you read that right, for free. Each tip is in the form of a handout and covers topics from getting started with breastfeeding and working from preemies, to increasing your milk supply, dealing with sore nipples, mastitis, jaundice, plugged ducts, thrush, oversupply and vasospams, going back to work, dairy intolerance, traveling with a breastfed baby and extended breastfeeding. She also addresses postpartum depression, tongue-tie and breastfeeding after a c-section in addition to other topics not mentioned here. Pretty much anything a parent needs to know about breastfeeding, well Dr. Becky Saenz has it covered. You can download them individually here. These handouts are a MUST HAVE for all lactation specialists and those aspiring to be. Best yet, they are written in accessible language and they are FREE!

Approval has been given to reproduce these handouts as long as they are for educational purposes only. If you’d like to receive more “Tips from the Trenches,” don’t hesitate to contact Becky at: drbecky@msbfmedclinic.com. Don’t forget to “like” Emerald Coast Alliance Breastfeeding Support Facebook page. Thank you Dr. Becky Saenz for creating these handouts and allowing free access – this allows us to disseminate knowledge and to help breastfeeding families all over the world.

Free Breastfeeding Tips & Guide Brochures by LLLI

bftipsandguide_360x475La Leche League International (LLLI) is offering pocket-sized Breastfeeding Tips & Guide booklets for free. You can order as many as you like, you just pay a flat $5 shipping rate (this shipping rate is valid in the USA, I’m not sure about foreign shipping rates). They are available in English and Spanish and you can order them here. Just a tip, they come as singles, so make sure if you want 25, 50, 100, etc. that you clarify the amount you want when ordering. You put quantity you want in your cart but aren’t charged anything but shipping at the end.

These little booklets are great to hand out at breastfeeding/baby fairs, prenatal and breastfeeding support groups or classes, maternity wards, clinics and pediatrician offices or even your private lactation practice. LLLI has granted its permission for the free distribution for the booklets (meaning: don’t charge money for them!). 

Check out an electronic view so you can see what topics the booklet addresses.


Are you aware of any other free breastfeeding brochures or booklets available? If so, please share them with me through my contact form or via Galactablog’s Facebook group.

Free Handouts: Depression, Breastfeeding & Related Topics in New Mothers (+ more!)

UppityScienceChick: Evidence-Based With Attitude is one of my new favorite sites that I’m incredibly excited to share with all of you. It’s run by the esteemed Kathleen Kendall-Tackett, Ph.D., IBCLC, FAPA and she provides a plethora of resources on breastfeeding, mothering, women’s health, postpartum depression and chronic diseases. Originally when I planned this post, I was writing it solely to share the FREE handouts on depression in new mothers but then as I explored her site more deeply, I become enthralled.

I had no idea that she was the author of one of my favorite breastfeeding books for new moms (easy and simple to read, to the point), titled, Breastfeeding Made Simple: 7 Natural Laws for Nursing Mothers

See here for FREE handouts on “Treatment for Depression” (topics included are in yellow box below)

treatments for depressionSee here for FREE handouts on “Depression, Breastfeeding and Related Topics” (topics included in the orange box below)

related topics

Kathleen Kendall-Tackett has also written (or collaborated on) over 17 articles on the Stress-Lowering Effects of Breastfeeding, which you can find here.

On her Postpartum Depression Home Page, there are 2 articles available for access:

Kendall-Tackett, K. A. (2007). A new paradigm for depression in new mothers: The central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health. International Breastfeeding Journal, 2:6

New Hampshire Breastfeeding Task Force. A breastfeeding-friendly approach to depression in new mothers: A Curriculum and Resource Guide for Health Care Providers. 2009 Edition.

And there’s more! She’s also published 2 more books:

All of these articles are open access. You are welcome to use, post or share any or all of them. If you would like reprint them, please contact Kathleen Kendall-Tackett  for the actual Word files. 

Free Academy of Breastfeeding Medicine (ABM) Clinical Protocols (Handouts)

abm_logoAs a lactation specialist who does lots of hospital consultations abroad, I’ve found the Academy of Breastfeeding Medicine’s (ABM) Clinical Protocols to be extremely helpful – particularly in instances where physicians and/or other healthcare professionals are giving recommendations or advice that will create impediments or “booby traps” for breastfeeding. Having evidence-based research at your fingertips not only assists the breastfeeding families seeking your help and expertise but can perhaps educate a few healthcare professionals along the way as well.

The clinical protocols are offered in several different languages (English, German, Spanish, Korean and Japanese) and cover a whole range of breastfeeding-related topics including supplementation, jaundice, milk storage, galactogogues, mastitis, engorgement, use of anti-depressants, model hospital policy, hypoglycemia, etc.). You can find all of the clinical protocols here.