Lactation. Diet during lactation. Complications of lactation. Medications and diseases during lactation. Acute cytomegalovirus infection. Drugs allowed during lactation

Diet ( food) during lactation

In addition, it is essential to ensure that enough fluids into the body, as dehydration ( loss of large amounts of fluid) may be accompanied by a decrease in the amount of breast milk produced.
At normal temperature air, a nursing woman is recommended to consume at least 2.5 liters of fluid per day ( in the absence of diseases of the cardiovascular system, edema and other contraindications), and in the heat - about 3 - 4 liters.

Products that increase ( improving, stimulating) lactation

Increase lactation contribute to:

• meat broths ( from lean meat, for example, from turkey);
• cheeses;
• carrot juice;
• cheese ( cow or sheep);
• fresh milk ;
• dairy products;
• buckwheat;
• herculean porridge;
• wheat porridge;
• dried fruit compotes;
• fresh juices;
• jelly;
• sunflower seeds .

Do walnuts increase lactation?

At the same time, it should be noted that in the core walnut contains essential oil. Although its proportion is relatively small, it can be included in the composition of breast milk and, together with it, penetrate the body of a newborn child, thereby causing the development of allergic reactions in him ( skin rash). Here's Why You Shouldn't Overeat Nuts While Breastfeeding that is, you do not need to take them in large quantities), and if a child has signs of an allergy, this product should be completely excluded from the diet.

Products that reduce ( reducing) lactation

The suppression of lactation can contribute to:

• spices;
• diuretic herbs ( lemon balm, linden, St. John's wort);
• black pepper;
• smoked products;
• canned food.

Can I drink coffee while lactating?

If a nursing woman drinks coffee, some of the caffeine that enters her body is included in breast milk and can enter the baby's body with it. However, it is worth noting that with reasonable coffee consumption, the concentration of caffeine in milk is negligible. So, for example, when drinking 1 cup of coffee ( containing about 100 mg of caffeine) about 0.5 mg of this substance will enter the breast milk of a woman. This is too little to in any way affect the cardiovascular system or the central nervous system of the child. That is why breastfeeding women can drink 1-3 cups of coffee a day without fear of harming the baby.

At the same time, coffee consumption in large quantities ( 5 or more cups per day) may be accompanied by a pronounced increase in the concentration of caffeine in breast milk, which can lead to the development of complications in the child. This can manifest itself as an increase in heart rate and an increase in blood pressure, anxiety, tearfulness, and so on.

Can I drink alcohol during lactation?

At the same time, it is worth remembering that the use of strong alcoholic beverages ( vodka, cognac and so on) in large quantities is accompanied by a pronounced increase in the concentration of ethyl alcohol in the mother's blood and in her breast milk. Increased concentration alcohol can be stored for 5-10 or more hours, which depends on the amount of alcohol taken, as well as on the condition of the patient's liver ( alcohol is detoxified in the liver). If, after drinking a large amount of alcohol, a woman breastfeeds a child, part of the alcohol will enter the child's body along with breast milk, which will cause him a series of side effects associated with the effect of ethyl alcohol on the central nervous system and other organs. This can be manifested by severe drowsiness and lethargy of the child, a decrease in his immunity ( the body's defenses), liver and kidney diseases ( with prolonged intake of alcohol in the body) and so on. In addition, these children may develop an increased resistance to alcohol, which will contribute to the development of alcoholism in them ( pathological addiction to alcoholic beverages) in adulthood.

Complications of lactation ( cracked nipples, milk stasis, mastitis)

The development of complications during lactation can contribute to:

• irregular feeding of the child;
• maternal malnutrition;
• non-compliance with the rules of personal hygiene by the mother;
• decreased immunity in the mother.

• Cracked nipples. Cracked nipples can appear after the start of feeding a child in almost any woman ( especially in the presence of predisposing factors listed above). The appearance of cracks is accompanied by severe pain in the nipple area, especially during feeding. This can negatively affect a woman's central nervous system, resulting in a decrease in her milk supply ( Or will it disappear altogether). In addition, in the area of ​​\u200b\u200bthe crack, the protective properties of the skin are violated, which creates favorable conditions for infection.
• Stagnation of milk. AT normal conditions milk is secreted from the ducts of the lobules of the mammary gland with each feeding or pumping. If for a long time ( 2 – 3 days) milk is not removed from a certain segment ( for example, during a break in feeding, after an injury, and so on), it thickens and clogs the excretory duct. At the same time, the newly formed milk cannot be released outside, as a result of which it stagnates in the breast tissue, which manifests itself painful induration. To eliminate this pathology, it is recommended to apply the baby to the affected breast more often, regularly massage the gland, and, if necessary, express milk. If the disease does not go away within 2 days, as well as with the development infectious complications (accompanied by fever and increasing pain in the area of ​​the affected gland) it is recommended to consult a doctor immediately.
• Mastitis. This is an inflammatory lesion of the mammary gland, accompanied by severe pain, enlargement and thickening of the breast tissue, as well as a possible increase in body temperature and other infectious complications. Nipple cracks can contribute to the development of mastitis ( through which the infection can penetrate into the tissue of the gland), as well as milk stagnation, which disrupts blood microcirculation and creates optimal conditions for development pathogenic microorganisms. To treat mastitis, it is necessary to regularly empty the gland from milk, as well as monitor compliance with the rules of personal hygiene. With the development purulent complications may require the use of antibiotics or surgical opening of the abscess ( breastfeeding during treatment this case will have to stop).

painful lactation ( Why do nipples and breasts hurt during lactation?)

If pain occurs in the mammary gland during lactation, the cause of their occurrence should be identified and eliminated as soon as possible, otherwise the risk of developing infectious complications increases, which can adversely affect the health of the mother, as well as the lactation process itself.

Why do seals appear in the mammary gland and the chest hurts after lactation is completed?

To prevent the accumulation of milk and the appearance of pain, it is recommended to wean the baby from the breast gradually, for several weeks in a row, reducing the number of attachments to the breast and increasing the proportion of complementary foods. At the same time, the amount of milk produced will also gradually decrease. If in this case pain does occur, they will be moderate and disappear on their own within a few days.

If it is impossible to gradually wean the child from the breast, with the appearance of arching pains, it is recommended to express breast milk daily. This will temporarily reduce the severity of the pain syndrome, as well as prevent milk stagnation and the development of infectious and inflammatory complications. In the future, to suppress lactation, you can use medication or folk remedies ( pills, herbs, infusions and so on).

Why do browns appear ( bloody) discharge from the breast during lactation?

The reasons for the appearance brown discharge during lactation may be:

• Cracked nipples. The formation of cracks can be accompanied by a violation of the integrity of tissues and damage to small blood vessels, the blood of which can mix with the secreted milk, giving it a brown color.
• Nipple injury. During feeding of children older than one year, they can damage the nipple with erupting teeth, as a result of which blood can also enter the milk.
• Stagnant milk. With stagnation of milk ( lactostasis) there is compression of the surrounding tissues and a violation of microcirculation in them, which can also be accompanied by damage to small blood vessels and the ingress of a small amount of blood into the duct of the breast lobule. With the resolution of lactostasis, the secreted milk may have a brown tint.
• Inflammatory diseases of the breast ( mastitis). If the development of mastitis is complicated by the formation of a purulent focus ( abscess), pus can destroy blood vessels and get into the lobules of the mammary glands, which will be accompanied by the release of a brown-gray purulent mass from the nipple. In this case, the patient will experience severe pain, and she will also have an increase in body temperature and pronounced redness of the skin over the affected mammary gland, which will distinguish this pathology from other, less dangerous complications.

Is it possible to have sex while lactating?

At the same time, it is worth remembering that childbirth through natural birth canal- This is an extremely traumatic process, after which the external genital organs of a woman must recover. That is why it is not recommended to resume sexual activity for at least 1-2 months after the birth of a child.

Is it possible to get pregnant during lactation?

The mechanism of action of lactation as a method of contraception is based on hormonal changes occurring in the female body. For pregnancy to occur, it is necessary that a woman's ovaries develop and mature in her ovaries. sex cell (egg). For this to happen, from the pituitary gland ( a special gland located in the brain that produces various hormones) 2 hormones should be secreted - follicle-stimulating hormone ( FSH) and luteinizing hormone ( LG). Without them, the maturation of the egg is impossible. However, during breastfeeding, irritation of special nerve receptors in the area of ​​the nipple of the mammary gland stimulates the production of another hormone - prolactin. Prolactin ensures the formation of milk in the mammary gland, at the same time, inhibiting the formation of FSH and LH in the pituitary gland, thereby preventing the development of the female germ cell and making pregnancy impossible.

An important condition for maintaining the process described above is the regular attachment of the child to the breast, which ensures that the concentration of prolactin in the blood is maintained at a sufficiently high level. If you take breaks in feeding ( even before the child reaches the age of 6 months), this may be accompanied by a periodic decrease in the concentration of prolactin. As a result of this, FSH and LH may begin to be released, which will start the process of maturation of the female germ cell. If the woman then has sex without using other methods of contraception, she may become pregnant.

Signs of pregnancy during lactation

The presence of pregnancy during lactation may indicate:

• unreasonable nausea;
• vomit;
• taste change;
• breast enlargement ( observed during lactation, so it cannot be considered a reliable sign);
• soreness in the nipples ( may also be observed in breastfeeding );
• increased appetite;
• frequent urination ( associated with bladder compression by a growing fetus);
• an increase in the abdomen;
• disappearance of menstruation can only indicate pregnancy if, after the birth of the child, the woman's menstrual cycle was restored).

Why do lymph nodes become inflamed during lactation?

Lymph nodes are a kind of filters through which lymph ( fluid found in almost all tissues of the body) flows away from tissues. If an infection enters the tissues, infectious agents or their toxins are trapped in the nearest lymph node. The immune cells located there protective) systems begin to actively fight the source of infection, which is accompanied by their active division and an increase in the size of the lymph node.

From the mammary gland, lymph flows into the axillary lymph nodes. With the development of mastitis, as well as when infection enters the breast tissue ( for example, through cracked nipples) infectious agents will quickly enter the axillary lymph nodes, which will be accompanied by their painful increase. In this case, you should consult a doctor as soon as possible and start a specific treatment for the disease, since with further development infections, bacteria and their toxins can enter the systemic circulation, which can lead to the development of much more severe, life-threatening complications.

How long after lactation do periods start?

Under normal conditions, to maintain lactation, it is necessary high concentration prolactin hormone in a woman's blood. This is ensured by regularly applying the baby to the breast and irritating the corresponding nerve receptors, which triggers the synthesis of the hormone in the pituitary gland. Prolactin inhibits the development of the female germ cell in the ovaries, thereby disrupting menstrual cycle and preventing the onset of menstruation. Therefore, than longer woman breastfeeds the baby regularly), the later she gets her period.

If you stop breastfeeding, after a few weeks another egg may begin to mature in the ovaries ( female sex cell), which can soon lead to the appearance of menstruation.

Why do menstruation occur during lactation?

Hair loss during lactation

The cause of hair loss during lactation can be:

• Hormonal changes in the body. In particular, fluctuations in the level of female sex hormones observed before and after childbirth.
• Lack of nutrients and vitamins. During childbearing, some trace elements and vitamins ( in particular iron, folic acid and vitamin B12) passes from the mother to the fetus. During feeding, these substances are also passed to the baby along with breast milk. If at the same time the woman does not receive increased amount proteins, fats, vitamins and microelements with food, a number of disorders can develop in her body, one of which will be hair loss.
• Stress and nervous strain. Stress during childbirth chronic sleep deprivation during the first months after them, it can disrupt the functions of the central nervous system and endocrine system, which can also be accompanied by a violation of trophism ( nutrition), increased fragility and hair loss.
• Wrong hair care. Paying all attention to a newborn child, a woman can deprive herself and her hair of attention. Infrequent shampooing, poor combing, and stopping the use of nourishing balms and other similar substances may contribute to hair loss postpartum period.

Is it possible to sunbathe / visit a solarium during lactation?

What medicines can be taken during lactation ( antibiotics, antihistamines, antivirals, sedatives, activated charcoal)?

During lactation, you should be careful when taking:

• antibiotics. The drugs of choice during lactation include penicillins ( augmentin, amoxicillin). They penetrate into milk in very small concentrations, and therefore, when using them, you can continue to breastfeed your baby. However, it is important to remember that even a small amount of an antibiotic in breast milk can be enough to cause an allergy in a child. When using other antibacterial drugs and if the child is allergic to penicillin antibiotics you should refrain from breastfeeding for the entire period of treatment. At the same time, milk should be expressed regularly so as not to disturb the lactation process and resume feeding the child immediately after stopping the medication.

• antihistamines ( suprastin, cetirizine). These drugs are used to treat allergic reactions. They easily penetrate into breast milk and can harm the baby's body, affecting its central nervous system, cardiovascular system, blood system, sensory organs, and so on. That is why it is recommended to interrupt breastfeeding during treatment with these drugs.
• Antiviral drugs. During the use of antiviral drugs, it is also recommended to stop breastfeeding the baby. An exception may be preparations based on interferon ( natural component, which is part of protective cells immune system human). The mechanism of their action is to enhance the natural protective ( antiviral) forces of the body, and they themselves have practically no negative effect on breast milk or on the child.
• Sedatives. The mechanism of action of most sedatives is to inhibit the functions of the central nervous system, which reduces nervous tension and makes it easier to fall asleep. If such substances enter the body of a child with mother's breast milk, this can lead to severe depression of the baby's central nervous system and the development of a number of complications ( drowsiness, lethargy, lethargy, and with prolonged use - to a lag in mental and physical development ). That is why it is not recommended to use any sedative medications during lactation.

Complications may develop with long-term regular use of this drug, as this will disrupt the absorption of nutrients in the intestine, which may be accompanied by a weakening or cessation of lactation. That is why activated charcoal should be used in short courses ( no more than 3 consecutive days) and only if there is evidence ( i.e. signs of food poisoning or intestinal infection).

Painkillers for headache and toothache during lactation ( paracetamol, nurofen, ibuprofen, diclofenac, citramon, nimesil, analgin)

For headaches and other pains, you can take:

• Paracetamol (500 mg orally up to 4 times a day). About 0.2% of the drug is excreted in a woman's breast milk, but it has minimal effect on the child.
• ibuprofen, nurofen (inside 200 - 800 mg 2 - 3 times a day). This drug is allowed to be taken during lactation, despite the fact that a small part of it still enters the mother's breast milk.
• Diclofenac(inside 25 - 50 mg 2 - 3 times a day). It is allowed to take only if it is not possible to use other painkillers.

• Citramon. It contains acetylsalicylic acid ( aspirin, contraindicated in lactation), as well as caffeine, which can enter the baby's body with mother's breast milk and negatively affect his cardiovascular and central nervous system.
• Nimesil. It can penetrate into the body of a child with breast milk, leading to impaired renal function.
• Analgin. It can penetrate the child's body and affect his hematopoietic system.

Contraception during lactation ( Can I take contraceptives while breastfeeding?)

For the treatment of hemorrhoids, you can use:

• Relief candles. Should be entered in anus 1 candle 4 times a day. They have anti-inflammatory and wound healing effects. The drug is not contraindicated in lactation.
• Candles hepatrombin G. Combined drug with anti-inflammatory action, which prevents the formation of blood clots ( blood clots ) in dilated veins, thereby contributing to speedy recovery female patients. Suppositories should be inserted into the anus after each act of defecation ( but no more than 2 times a day). The drug is not contraindicated in lactation.
• Sea buckthorn oil ( candles). Has a wound healing effect. For the treatment of hemorrhoids, 1 suppository should be injected into the anus ( 500 mg) 2 times a day. Can be used during lactation.
• Heparin ointment. Used for application to hemorrhoids ( for the treatment and prevention of thrombosis). Heparin does not penetrate into breast milk, and therefore is not contraindicated in lactation.

Is it possible to use vasoconstrictor nasal drops during lactation?

These drops are used for nasal congestion, which can be observed with colds, allergic reactions and so on. The mechanism of their action is associated with the narrowing of blood vessels and the elimination of swelling of the nasal mucosa, which facilitates nasal breathing. This does not affect the lactation process in any way, however active ingredients drops can enter the systemic circulation ( in very small quantities) and be excreted from the mother's body with breast milk, which can lead to the development of allergic and other undesirable reactions in the child. However, no studies proving the harm of vasoconstrictor drops for a child during breastfeeding have been conducted. In the presence of strict indications, drugs can be used to eliminate nasal congestion, but only in short courses ( no more than 2 - 3 days).

Do I need to take iron while lactating?

To prevent iron deficiency during pregnancy and lactation, you can take:

• Hemopher prolongatum- inside 100 - 200 mg 1 time per day.
• Sorbifer durules- Inside, 1 - 2 tablets per day.
• Ferro-foil- inside 1 - 2 capsules twice a day ( after meal).

Vitamins ( B6, B12, D) during lactation

Most vitamins enter the mother's body with food ( with full and varied diet ). At the same time, some vitamins should be administered additionally in the form of medicines, since the need for them during lactation increases.

During lactation, a woman can be prescribed:

• Vitamin B6. Takes part in metabolism, and is also necessary for the normal formation of red blood cells ( red blood cells). The daily requirement during lactation is 2.2 mg.
• Vitamin B9 ( folic acid). This vitamin is necessary for ensuring the processes of cell division throughout the body. The daily requirement for it during lactation is 300 micrograms.
• Vitamin B12. This vitamin is necessary for normal metabolism in the body, as well as to prevent the development of anemia ( anemia). The daily requirement during breastfeeding is 2.8 micrograms.
• Vitamin D. Required for normal development bone tissue, as well as for the normal functioning of the immune ( protective) body systems, for metabolism and so on. During lactation, a woman should receive at least 600 International Units of vitamin D per day.
• Vitamin C ( vitamin C) . It is necessary to ensure metabolism at the cellular level, as well as to maintain the strength of the walls of blood vessels, for the synthesis of many biologically active substances, and so on. When breastfeeding daily requirement in this vitamin is 120 mg.

Treatment of cystitis, thrush, sinusitis, constipation, diarrhea, tonsillitis, cough and other diseases during lactation

During lactation may develop:

• Cystitis. This is an infectious disease Bladder, accompanied by frequent urination, as well as pulling pains in the lower abdomen. Treatment consists of plentiful drink, as well as in the use of antibacterial drugs that can be excreted in breast milk. That is why it is recommended to interrupt breastfeeding for the period of treatment.

• Thrush. it fungal disease, in which pathogenic fungi can affect a variety of parts of the body ( nails, mucous membranes, gastrointestinal tract and so on). Patients may experience severe pain or burning in the area of ​​the mucous membranes of the genital organs, pain when urinating, pathological discharge from the vagina can be observed, and so on. Treatment consists of using antifungal drugs both locally and systemically. Since most of them are systemic use pass into breast milk, for the period of treatment should refrain from breastfeeding.
• Sinusitis. This is an infectious and inflammatory lesion of the paranasal ( maxillary) sinuses, accompanied by inflammation and swelling of their mucous membranes and accumulation of pus in the sinuses themselves. Purulent sinusitis can be complicated by the spread of infection to the brain tissue, and therefore the treatment of the disease should be the use of potent antibiotics. Breastfeeding should be discontinued until the patient has fully recovered.
• Constipation. For the treatment of constipation, laxatives can be used that do not enter the systemic circulation and are not passed to the baby along with breast milk ( duphalac, glycerin suppositories and so on). Breastfeeding should not be interrupted.
• Diarrhea. To treat diarrhea, first of all, you need to identify its cause. If the cause is an infectious disease of the gastrointestinal tract, treatment should begin with washing the stomach and intestines. After that, the patient should be given activated charcoal preparations, which will also accelerate the removal of toxins from the body. Use antidiarrheals ( from diarrhea) funds ( such as loperamide) during lactation is prohibited, as they can enter the body of the child along with breast milk.
• Angina. This is an inflammatory disease of the palatine tonsils, caused by pyogenic bacteria. The main treatment for angina is the use of potent antibiotics, which requires a temporary cessation of breastfeeding.
• Cough. Cough can develop with colds, flu, and other respiratory infections. Lozenges can be used to fight infection in the upper respiratory tract and to relieve coughs ( septolete, pharyngosept and others) that have antibacterial action and absolutely safe during lactation.

High temperature during lactation

The reasons for the increase in temperature during lactation can be:

• milk stasis;
• mastitis ( breast inflammation);
• infection of the genitourinary system;
• upper respiratory tract infection;
• cold;
• food poisoning;
• intestinal infection;
• chronic diseases of the mother and so on.

But, unfortunately, in some cases, there may be contraindications and obstacles to breastfeeding.

Contraindications for breastfeeding:

From the mother's side:

• operation in childbirth;
• severe forms of toxicosis during pregnancy;
• severe bleeding in the birth and postpartum period;
• general disorder due to chronic diseases liver, kidneys, heart;
• oncological diseases, chemotherapy;
• blood diseases;
• HIV infection at mother. At positive analysis for HIV - milk can be expressed and given to the child after sterilization;

The last five points are persistent (absolute) contraindications to breastfeeding. This means that the child of a woman with this pathology should under no circumstances be applied to the mother's breast.

Temporary (relative) contraindications for maternal health may include: C-section(stage of post-anesthetic sleep, syphilis, tuberculosis (open form), acute intestinal infections, infectious diseases: typhus and relapsing fever, anthrax, tetanus in acute period, purulent mastitis). When a mother develops acute contagious diseases ( erysipelas, typhoid, blood poisoning), she should be expressed, sterilized milk and given to the child. With flu, sore throat - breastfeeding is allowed, but the mother must have a hygienic mask.

In the presence of gynecological diseases breastfeeding continues, but it is important strict observance hygiene. If the mother is sick with syphilis, then the issue of feeding is decided depending on the period of infection: if infected after 6 months of pregnancy, feeding is prohibited, if infected before this period, breastfeeding is possible. If the mother is ill with tuberculosis, the child is isolated from her for 2 months, but feeding with expressed sterilized milk is allowed.

From the side of the child:

• severe condition of the newborn;
• deep prematurity;
• serious malformations (heart, maxillofacial apparatus, digestive system, etc.);
• violation cerebral circulation;
• severe jaundice of the newborn;
• metabolic diseases with impaired production of certain enzymes in the body;

Such children need to be fed with expressed milk, because due to their weakness they cannot suck it out of their mother's breasts.

Difficulties with breastfeeding:

From the side of the child:

• malformations of the jaws and nose (it is necessary to adapt or, at first, feed the child with expressed breast milk through a probe or from a spoon);
• fungal infection oral cavity- thrush;
• sluggish, lazy sucking;
• swallowing air, frequent regurgitation;
• nasal congestion;

From the mother's side:

• altered shape of the nipples (inverted, pointed, poorly developed). In this case, nipple massage will help, the use of special triangular-shaped pads (in the form of a “clover leaf”) for the physiological contact of the baby’s nose with the mother’s skin;
• tight breasts (stagnation of milk). To improve the outflow of milk, it is necessary to express a small amount of it before feeding the baby, to massage the gland;
• cracks and abrasions of the nipples. For treatment, you can use UV radiation, every other day 5-6 times, lubrication of cracks with creams containing lanolin;
• mastitis. In this case, you need to feed with expressed sterilized milk;
• increased secretion of milk - galactorrhea;
• the onset of a new pregnancy in a nursing mother. Usually it does not affect lactation and the composition of milk, therefore, up to 5 months of pregnancy, a woman can put her baby to her breast;
• reduced milk secretion - hypogalactia;

It can be said that it is desirable for lactating women to avoid drug treatment. However, of course, life situations may arise when a mother cannot do without medicines. In the event of postpartum complications, with exacerbation of chronic diseases, with the development of serious acute diseases, it is impossible to delay treatment.

In such cases, when choosing drugs, it is necessary to evaluate their toxicity and possible adverse effects on the child's body, after which it is desirable to choose those drugs that are the least toxic and that do not penetrate well into breast milk. It is important to discuss the need and safety of treatment with the prescribing physician. And you should also consult with a pediatrician, specifying the possible side effects of the drug on the child's body.

Below is a summary of data by drug group. Given that there are very few adequate studies, information on many drugs can be contradictory.

Antacids and enveloping. Antacids - drugs that neutralize acidity gastric juice, enveloping - drugs that prevent damage to the gastric mucosa. These drugs are prescribed for gastroduodenitis ( inflammatory diseases stomach and duodenum), peptic ulcer stomach and duodenum.

DENOL. Contraindicated in breastfeeding

VENTER. May be used with caution.

ALMAGEL, MAALOX PHOSFALUGEL and the like

Antiplatelet agents. Drugs that reduce blood viscosity are used to improve blood circulation in the capillaries in various diseases, for example, in pathologies of the heart, blood vessels, and kidneys.

CURANTIL. Possible short-term use during breastfeeding.

TRENTAL. Contraindicated.

Antibiotics. They are used to treat various infectious and inflammatory diseases, such as mastitis (inflammation of the mammary gland), endometritis (inflammation of the inner lining of the uterus), salpingo-oophoritis (inflammation of the ovaries and fallopian tubes), tonsillitis, pyelonephritis (inflammation of the kidneys), pneumonia (inflammation of the lungs), with some intestinal infections and etc.

Penicillins (PENICILLIN, AMPICILLIN, AM-PIOX, AMOXICILLIN AMOXYCLAV and others.), cephalosporins (CEFAZOLIN, ZINNAT, CEFOTAXIM, FORTUM, CEFTRIAXONE MAXIPIM, etc.), macrolides(ERYTHROMYCIN, SUMAMED VILPROFEN, MA-CROPEN, etc.), aminoglycosides (NETROMYCIN, GENTAMYCIN, AMIKACIN) are not usually contraindicated in breastfeeding.

Penicillins, cephalosporins, aminoglycosides pass into milk in small amounts, so their toxicity to the child is low. Macrolides penetrate well into milk, but their use during breastfeeding is possible. Available potential risk development of complications associated with the occurrence of allergic reactions, impaired normal flora intestines (diarrhea), reproduction of fungi (candidiasis - thrush). For the prevention of dysbacteriosis, it is recommended to appoint a child probiotics (BIFIDUM BACTERIA, LINEX etc.). When allergic reaction the child should stop taking this antibiotic or temporarily stop breastfeeding.

Tetracyclines, sulfonamides (BACTRIM, BI-SEPTOL and etc.), METRONIDAZOL, clindamycin, lincomycin, levomycetin, ciprofloxacin penetrate into milk, and the probability negative reactions high. It is recommended to avoid their use during breastfeeding. Side effect clindamycin- risk of gastrointestinal bleeding. Side effect LEVOMICETIN- toxic injury bone marrow influence on the cardiovascular system. Side effect tetracyclines- growth retardation of the child, impaired development of bone tissue and tooth enamel.

Antihypertensive agents. Used for high blood pressure.

DIBAZOL. Compatible with breastfeeding. Read more - therapeutic effect and indications for the use of dibazol during feeding.

DOPEGIT. Usually not contraindicated in breastfeeding.

VERAPAMIL (ISOPTIN).

ACE inhibitors (ENAP KAPOTEN). There are no adequate studies. Their use during breastfeeding is contraindicated.

DIAZOXIDE. Contraindicated in breastfeeding. Side effect - hyperglycemia (increase in blood sugar).

RESERPINE. Contraindicated.

Antihistamines (SUPRASTIN, TAVEGIL, CETIRIZINE, LORATADIN). Appointed at allergic diseases. The use of these drugs is possible with breastfeeding. Preferred CETIRIZINE, LORATADINE, since 1st generation antihistamines ( SUPRASTIN, TAVEGIL) can cause drowsiness in a child.

ERIES. Contraindicated.

Antidepressants. They are used to treat depression, including postpartum.

AMITRIPTYLINE. The concentration in breast milk is very low. In newborns whose mothers received AMITRIPTYLINE, no abnormalities were observed, therefore this drug is considered compatible with breastfeeding.

There are no studies on other drugs in this group or they are not recommended for breastfeeding.

During treatment postpartum depression antidepressants may be prescribed selective inhibitors reuptake of serotonin FEVARIN (FLUVOXAMINE)), FLUOXETINE, PAROXETINE, SERTRALINE and etc.). According to doctors, these drugs can be used with caution during breastfeeding. However, in the instructions for the drugs, the manufacturer does not recommend their use during breastfeeding, due to the lack of adequate studies.

We analyze the question "Treatment of postpartum depression: antidepressants are not a panacea and how to deal with the problem?"

Anticoagulants. Drugs that prevent blood clotting. They are used for increased blood clotting, the risk of increased blood clots, heart disease.

HEPARIN WARFARIN. Usually not contraindicated in breastfeeding, as they penetrate into breast milk in minimum quantities. With long courses (more than 2 weeks), there is a potential risk of a decrease in blood clotting in a child.

Anticoagulants indirect action (FENILIN). Contraindicated in breastfeeding, taking drugs can cause bleeding.

Antiseptics of local action. Preparations for the prevention and treatment of local infections.

HYDROGEN PEROXIDE, CHLOROHEXIDINE, FUCARZIN, "brilliant green"

Antithyroid drugs. They are used for diseases of the thyroid gland, occurring with an increase in its function.

Apply with caution, controlling the condition of the child. Side effect - suppress the function of the thyroid gland of the child.

Benzodiazepines. A group of drugs that reduce anxiety, soothing.

It is believed that a number of drugs from this group ( DIAZEPAM, CLONAZEPAM, LORAZEPAM, DORMIKUM, TEMAZEPAM) is compatible with breastfeeding if used a short time. Side effects - depression of the central nervous system, respiratory depression.

Bronchodilators. Drugs that dilate the bronchi. They are used to stop attacks of bronchial asthma.

SALBUTAMOL, TERBUTALIN, FENOTEROL. It is believed that they are acceptable for feeding. It is necessary to monitor the condition of the child, side effects - excitement, increased heart rate.

Venotonics (DETRALEX). Applicable for venous insufficiency, varicose veins, hemorrhoids. There are no data on penetration into breast milk, therefore it is better to refuse the use of these drugs during breastfeeding,

Vitamins, vitamin-mineral complexes, minerals. Used for breastfeeding. Side effects- allergic reactions.

Hormones(PREDNISOLONE, DEXAMETHASONE, HYDROCORTISONE). Used for autoimmune diseases (rheumatoid arthritis, systemic diseases connective tissue, autoimmune hepatitis, etc., with certain blood diseases, with adrenal insufficiency, etc.).

Usually not contraindicated in breastfeeding. However, safety with long-term use has not been proven, therefore, if treatment is necessary for more than 10 days, the issue of continuing breastfeeding is decided individually. If a breastfeeding woman needs long-term treatment a high dose of hormones (2 times more physiological), it is believed that breastfeeding should be avoided.

Thyroid hormones (EUTHIROX). They are used for insufficient thyroid function.

Can be used under the supervision of the child. Side effects - increased heart rate, excitability, diarrhea, decreased weight gain.

Diuretics(diuretics). Used in the treatment hypertension, heart failure, with "renal edema". When using diuretics, there is a risk of lactation suppression, so their use is not recommended during lactation.

The most severe restrictions are set for the group thiazides(HYPOTHIAZIDE), they are contraindicated in breastfeeding.

FUROSEMIDE (LASIX) may be used with caution.

DIACARB indicated for increased intracranial pressure. May be used as concentration in breast milk is too low to cause harmful effect on a child.

Antipyretics.

PARACETAMOL not contraindicated in breastfeeding if used in usual dose and several times (1 tablet up to 3-4 times a day, no more than 2-3 days). overdose and long-term use should be avoided, as a side effect of the drug is a toxic effect on the liver and blood.

How does paracetamol work and why is it the basis of all antipyretic drugs allowed during feeding: Indications and contraindications for the use of paracetamol during feeding

Choleretic agents. They are used for diseases of the liver and gallbladder, accompanied by stagnation of bile. Not contraindicated in breastfeeding.

(In the instructions for the drug URSOFALC indicated that studies have not been conducted.)

Inhaled corticosteroids (beclomethasone, bbcotide, flixotide and etc.). Used to treat bronchial asthma. Not contraindicated.

Antidiarrheals.

IMODIUM. The drug passes into breast milk, so it is not recommended, but a single dose is possible.

Intestinal sorbents. They are used for poisoning, intestinal infections, allergic diseases.

Activated carbon, SMEKTA, ENTEROSGEL etc. Compatible with breastfeeding.

Contraceptives

During breastfeeding, drugs with a predominant content of progesterone are allowed ( EXCLUTON, MICROLUT. CHAROSETTA, CONTINUINE). Other drugs are contraindicated in breastfeeding.

Gynecologists say in one voice: Allowed contraceptives during breastfeeding

local anesthetics. Used when local anesthesia is needed.

Lidocaine, Articaine, Bupivacaine. Compatible with breastfeeding.

Methylxanthines(CAFFEINE, EUFILLIN). CAFFEINE used to stimulate the nervous system, with low blood pressure, is part of drugs with analgesic action, such as KAFFETIN, CITRAMON. EUFILLIN applies when bronchial asthma to dilate the bronchi.

These drugs are not usually contraindicated while breastfeeding, but should be used with caution. They penetrate well into breast milk and are slowly excreted from the body of the newborn. Side effects - sleep disturbance, agitation, regurgitation, diarrhea, cardiovascular reactions.

Nootropics(means that improve attention, memory) and drugs that improve cerebral blood flow ( STUGERON, PIRACETAM. CAVINTON, TANAKAN, PHENIBUTE, PANTOGAM, GLYCINE and etc.).

The drugs in this group are compatible with breastfeeding.

Painkillers. They can be non-narcotic and narcotic.

Non-narcotic: PARACETAMOL(see above), ANALGIN, KAFFETIN, BARALGIN. Compatible with breastfeeding with single applications. Not recommended them long term appointment, since a side effect of these drugs is a toxic effect on various organs (liver, kidneys, blood, central nervous system, etc.).

Narcotic: Morphine, Tramal, Promedol, Naloxone. Penetrate into milk in small amounts, but may cause adverse reactions in newborns. A single dose of these drugs is possible. It is not recommended to take it again, as respiratory depression (apnea), slowing of the heart rate, nausea, vomiting, CNS depression, withdrawal syndrome are possible.

Expectorants. Used for various diseases respiratory system flowing with cough.

AMBROXOL, BROMHEXIN, ACC. Compatible with breastfeeding

Pre- and probiotics (LINEX, PRIMADOPHILUS. HILAK FORTE and etc.). Compatible with breastfeeding.

Prokinetics. Used for gastroesophageal and duodenogastric reflux- reflux of contents from the esophagus into the stomach or from the duodenum into the stomach. These conditions can be manifested by symptoms of gastritis (pain in the stomach, heartburn).

MOTILIUM. May be used with caution. Anti-inflammatory drugs.

ASPIRIN. Possible single doses of the drug. Long-term administration and high doses are not recommended, as the risk of serious side effects(decrease in platelets, toxic damage to the central nervous system, liver).

ibuprofen, diclofenac. In a few studies, it was determined that these drugs passed into milk in small quantities and their use did not cause adverse reactions in newborns. However, their long-term administration is not recommended.

NAPROXEN. The effect on the child is not known.

Antihelminthic drugs (DECARIS, PIRANTHEL).

Can be used while breastfeeding.

Antidiabetic drugs.

INSULIN. Usually not contraindicated in breastfeeding, but careful individual dose selection is required. Side effects - the development of hypoglycemic conditions (decrease in blood sugar) in a child.

Oral antidiabetic(hyperglycemic) drugs. Side effects: hypoglycemia up to coma (the likelihood of its development increases if the dosing regimen is violated and the diet is inadequate); nausea, diarrhea, feeling of heaviness in the stomach. Sometimes: skin rash, itching, fever, joint pain, proteinuria. Rarely: sensory disturbances, headache, fatigue, weakness, dizziness, pancytopenia; cholestasis, photosensitivity.

Contraindicated in breastfeeding.

Antiemetic drugs.

CERUKAL. Compatible with breastfeeding for short-term use.

Antiulcer drugs. Drugs that block the secretion of acid in the stomach.

omeprazole. No research.

RANITIDINE, FAMOTIDINE HISTODIL. Side effects - headache, dizziness, fatigue, skin rash, effect on the blood picture. Cases of development of hepatitises are described. The drugs are contraindicated in breastfeeding.

Psychotropic drugs. They are used for psychoses, neuroses ( AMINAZINE, DROPERIDOL, HALO-PERIDOL, SONAPAX and etc.).

Penetrate into milk in small amounts, however, since there is a risk of developing serious side effects, it is not recommended for breastfeeding without absolute readings. Side effects - depression of the central nervous system, impaired development of the nervous system.

Laxatives.

FORLAX, GUTTALAX, REGULAX, SENNA LEAVES. Compatible with breastfeeding in moderate doses.

Antispasmodic drugs.

NO-SHPA. Use during breastfeeding is possible.

Uroseptics and intestinal antiseptics. They are used to treat infectious and inflammatory diseases of the kidneys and intestines.

FURGIN. There are no adequate studies. According to the instructions - not recommended.

FURAZOLIDONE, MACMIROR, ENTEROFURIL, FURADONIN May be used with caution.

Nalidixic acid (NEGRAM, NEVIGRAMON). May be used with caution.

Enzymes. They are used to improve digestion in various gastrointestinal diseases.

MEZIM FORTE, CREON etc. Compatible with breastfeeding.

Alcohol while breastfeeding

A sip of wine in honor of something ... Already regular consumption of alcohol during pregnancy can harm the baby. However, this also applies to the feeding period, since the baby drinks with you when you do it. He may even be "drunk" and even blissfully "nod". And it is still very difficult for him to break down alcohol. Therefore, the use of alcoholic beverages is strictly prohibited.

However, when the guests arrived, it is expected tasty food or the day turned out to be especially difficult - you can, rarely and on a special occasion, drink a glass of champagne, light wine or a glass of beer. It doesn't hurt, on the contrary, such a small sip will probably relieve your tension and you can again take care of your child with more eagerness. However, caution is needed with spicy and strong drinks! Not only will they harm your baby, but your milk supply will also decrease.

If you drink a glass of wine, it is better to do this during feeding or immediately after it - 30-60 minutes after that, the alcohol content in the mother's milk will rise to the same level as in her blood. Until the next feeding, it will at least decrease again.

Sometimes a small sip to unload will help overcome difficulties with the flow of milk. But a glass should not become a habit!

Although alcohol during breastfeeding not as strictly prohibited as during pregnancy, its use should be moderate. Alcohol passes into breast milk and can pass to the baby. Although many experts believe that a small amount of alcohol given to a child in isolated cases is unlikely to cause problems, in general drinking in large quantities should be avoided. It's also good if you try not to feed your baby for two hours after drinking alcohol. This will minimize the amount that the baby will receive with breast milk. Alcohol in breast milk can make the baby drowsy and make it difficult to move.

There is also evidence that children suck out much less breast milk from a mother who has consumed alcohol; perhaps this is due to the fact that alcohol has a blunting effect on the breast milk ejection reflex. (Here's another reason not to drink champagne while breastfeeding!)

Smoking while breastfeeding

In Germany, 30% of all pregnant women smoke, while in Japan only 2%. However, you probably already knew for a long time that smoking is bad for your baby, both before and after childbirth. However, few smokers manage to completely stop smoking during pregnancy and lactation. Those women who cannot quit smoking are usually hesitant to breastfeed. However, this solution is wrong! Feeding, even in this case, should be preferred to refusing it. Better try to control your bad habit.

Compromise:

Try to reduce your daily number of cigarettes to a maximum of five.

Smoke after you have fed - then the nicotine will already be partly destroyed by the next feeding time, and your child will “smoke” less with you.

No one should smoke in the presence of a child, as passive smoking is harmful to the bronchi.

Maybe you can stop smoking those last five cigarettes too?

expose the child passive smoking always bad, but the worst is if you do it while breastfeeding. Breastfeeding mothers who smoke produce less milk than nonsmoking women. This may explain the fact that children whose mothers smoke are less likely to breastfeed. In addition, nicotine and other by-products Smoking gets into the mother's milk, and these are the substances that harm the baby.

It should also be added that in more than 50% of cases, smoking is associated with colic (a disease that occurs in newborns) and syndrome sudden death externally healthy child. So there are many reasons to quit smoking. If you can't quit the habit, smoke after feeding your baby, not before.

You should also smoke outside or in another room to reduce the amount of smoke your child might inhale. (These tips also apply to mothers who bottle-feed babies: smoking is bad for all babies, whether breastfed or formula-fed. This goes for friends who smoke, and all family members. If they want to smoke, they should get out of the house. ) Do not also think that if you smoke, you should not breastfeed your baby. It is better to smoke and feed a baby than to completely deprive him of breast milk.

Can I drink coffee while breastfeeding?

Although you feel like you've never needed a cup so much in your life strong coffee like now, in a period when you are deprived of sufficient sleep, there are many reasons why you should give up this drink. Frequent use foods containing caffeine (coffee, tea, cola, cocoa, chocolate, and some prescription and over-the-counter drugs) cause anxiety, overactivity, and insomnia in some breastfed babies.

Herbs for breastfeeding

You should pay attention to the composition of herbal tea. Find out what types of tea can be consumed during the feeding period and which cannot. If you are not sure, check with your doctor. Several newborn babies have died because their mothers drank large amounts of herbal tea. It is also risky to give any herbal tea little child if you do not know for sure whether the product is harmful to him.

You should be very careful with these products. They may be natural, but most of them contain pharmacologically active substances that can harm your baby. Few studies have been conducted on the effects of these products on a breastfed baby, so it is best to exercise caution unless you know for sure that the product is not contraindicated for breastfeeding mothers.

Contraindications to breastfeeding

Tuberculosis is a contraindication to breastfeeding

Mycobacterium tuberculosis is able to penetrate into mother's milk, at the same time, cases of infection of a child in this way (through milk) have not been recorded.

At active tuberculosis with the release of mycobacteria in environment(so-called. open forms) breastfeeding is contraindicated - high risk airborne infection.

In tuberculosis without isolation of mycobacteria (the so-called. closed forms) breastfeeding is allowed.

Viral hepatitis- contraindications to breastfeeding

In hepatitis A, breastfeeding in the acute period is contraindicated.

With hepatitis B and C, breastfeeding is allowed, but through special silicone pads.

streptococcal infection- contraindication to breastfeeding

Breastfeeding is possible at normal body temperature in a nursing mother and provided that adequate antibiotic therapy.

HIV infection is a contraindication to breastfeeding

Breastfeeding is contraindicated.

Acute cytomegalovirus infection

The virus passes into milk. Nevertheless, healthy full-term babies can be fed.

Herpes simplex virus infections

Breastfeeding is allowed provided that there are no rashes directly on the mammary gland.

What infections are breastfeeding allowed for?

If the general condition of the mother allows, then subject to standard hygiene rules breastfeeding is appropriate for:

• acute respiratory viral infections;
• acute intestinal infections;
• infectious mononucleosis;
• toxoplasmosis;
• measles;
• rubella;
• chicken pox;
• epidemic parotitis.

Postpartum lactational mastitis

Lactostasis - stagnation of milk in one or more areas of the mammary gland. Lactational mastitis is an inflammatory process in the mammary gland during lactation. There are no signs to clearly distinguish lactostasis and lactational mastitis from each other.

Lactostasis and lactational mastitis are actually two stages of the same process: lactational mastitis is a complication of lactostasis. In any case, feeding from a healthy breast should be continued in full. Feeding from the diseased breast should be continued if the pain is tolerable.

If you can express enough milk from a diseased breast to feed, then you can feed this milk, but most likely you are doing it wrong: if it is possible to endure pain during pumping, then you need to endure pain during feeding and apply the baby to the patient more often chest. If the pain is so unbearable that you can neither feed nor pump, it is direct reading to see a doctor. Numerous modern research proved that milk expressed during mastitis, even with an admixture of pus, is safe for feeding a child.

In some situations, breastfeeding is contraindicated. Let's find out which ones.

Maternal contraindications to breastfeeding

If you have had a double mastectomy or surgical reduction a breast where the nipples have been removed or the milk ducts have been severed, this will make feeding impossible. Also, if you have the AIDS virus, you should not breastfeed. There is evidence that in rare cases the virus was transmitted to the infant through mother's milk. A woman suffering from tuberculosis active form who have not been treated should also refrain from feeding.

A mother who uses cocaine or other drugs should not breastfeed because substances that pass quickly into milk can cause serious illness or even the death of a child. Other substances that also require temporary suspension of breastfeeding include radioactive isotopes, antimetabolites, cancer chemotherapy drugs, and a small number of other drugs.

Contraindications to breastfeeding by the child

If a child is diagnosed with galactosemia, they do not have liver enzymes and cannot digest lactose. Because in mother's milk there is a high content of lactose, then breastfeeding in this case is contraindicated. Continued feeding may cause mental retardation. The child must be switched to a special formula such as Nutramigen. Some states include this disease in the test, which is carried out on all babies for some dangerous diseases.