New Breastfeeding Medicine Consult Service provides patients with expert information on medications and breastfeeding

The faculty consult team has physicians from UNC OB-GYN, Family Medicine and Pediatrics.

New Breastfeeding Medicine Consult Service provides patients with expert information on medications and breastfeeding click to enlarge Dr. Alison Stuebe is an OB-GYN and expert in breastfeeding medicine..

A group of interdisciplinary faculty providers has formed the Breastfeeding Medicine Consult Service at UNC Hospitals to help mothers confidently make the best decisions about breastfeeding when they are also taking medications or managing an illness.

The faculty team from UNC OB-GYN, Family Medicine and Pediatrics is available to consult on mothers who are taking medications and have concerns about safely breastfeeding their children, questions about how maternal disease affects breastfeeding and how breastfeeding might affect that disease, as well as how a child's illness might affect breastfeeding and the effects breastfeeding might have on that child.

Providing this service ensures the patient is making breastfeeding decisions with the best information and scientific evidence available.

Misinformation about medication safety in breastfeeding is a common problem, said Dr. Alison Stuebe, associate professor of obstetrics and gynecology and Distinguished Scholar of Infant and Young Child Feeding at the Gillings School of Global Public Health.

"Providers often extrapolate what they know about medications in pregnancy, but that's not appropriate. The placenta and the breast are completely different organs. And that means that we can't assume drugs that are safe in pregnancy are safe in lactation, or vice versa," said Dr. Stuebe.

That's why Stuebe recommends that health care providers look up a medication before assuming it's safe - or unsafe - for breastfeeding. As of July 1, any individual with a UNC Onyen can access information on medication safety in lactation from "Medications and Mothers' Milk" by Thomas W. Hale, Ph.D., a worldwide best-selling reference, updated regularly, for evaluating medication use in breastfeeding mothers.

Guidelines for selecting medications for breastfeeding women and accessing reliable references are available on the MomBaby.org web site.  In most cases, a patient may be able to continue both breastfeeding and the medication safely, or an alternate medication may be available.

The consult service was formed to help provide counseling when a drug is of concern, or when a mother is on several medications. "Our goal is to support families and providers to make shared decisions, balancing the risks of interrupting breastfeeding with the risk of medication exposure," Stuebe said. If it's unclear whether a drug is safe, moms should express and store milk until a decision is made. "Never throw away a mother's milk!"

Whenever a breastfeeding mother or child is admitted, Stuebe recommends that the team consult through EPIC, the UNC Lactation Service to assist with maintaining breastfeeding. A team of International Board Certified Lactation Consultants (IBCLCs) helps mother-baby dyads who are experiencing a hospitalization to maintain their breastfeeding relationship.

"Our lactation staff will work with the family and care team to assist mom with meeting her breastfeeding goals during the admission. We provide assessment of current lactation processes and work to prevent additional complications from milk stasis, reduction of milk supply, or infant complications from reduced breastmilk intake," said Diane Asbill, lactation department coordinator for lactation services at N.C. Women's Hospital at the UNC Medical Center.

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