[shackles]

My husband has won a trip with his job to a location where we need to take antimalarial tablets, meaning that I need to stop breastfeeding while taking the antimalarial tablets and for a month afterwards. I've expressed enough milk so that for the 5 days that we are away my mother can give her my milk and then I was going to give her formula for a month and express and throw away my milk until my body was clear of the antimalarial drugs and then reestablish breastfeeding. However yesterday when I saw the nurse to have my travel jabs it seems that in order to take the typhoid and Hep A jab I need to stop breastfeeding earlier - two weeks time! This would mean I would have to express and throw away for 7 weeks.

It was a very difficult decision to agree to go with my husband as breastfeeding was very difficult at the start but I've now got to the stage where its now longer agony. My daughter is 14 weeks old and has nothing but breastmilk up until now. Am I a bad mother even considering going away for 5 days when my baby is 20 weeks and to compound this stopping breastfeeding and moving her to formula? My husband is happy to cancel the trip as I'm concerned about the breastfeeding but part of me thinks we need some time together and we are leaving my daughter with my mother who will give her the best possible care.

Has anyone expressed and thrown away milk for 7 weeks or longer and then been able to reestablish breastfeeding? Any advice would be gratefully received.

[carang]

you anr NOT a bad mother for wanting to go away with your hubby for 5 days!

i say, enjoy the time, it will most likely be the lst time for many years to come that you'll have the chance to do this.

i thnk so long as you continue to pump the same as you would if you were bf then you should be ok.

make a chart to help you kep track of how often and how much you are puming, otherwise you'll forget. this will also ease your mind by showing you that you are not losing your supply.

good luck & HAVE FUN!

[MayC]

Hi, instead of stopping completely, perhaps you could consider taking a double breasted pump on your trip and then only expressing 3 times a day while you are away on the trip. You could spend like 20 minutes in the morning expressing and then again during the day (like a long loo stop while hubby goes off doing some shopping nearby) and then one more time before you retire the night. After you get back from the trip, you could express more often again to increase your milk supply should you decide to keep up with it.

I expressed breastmilk exclusively for my daughter for 10 months and it WAS NOT easy and I think I was a nightmare to live with constantly relying on others to help me out. I spent so much time expressing that I had little time with her. After I stopped, I felt guilty but I suddenly had all these extra time to cuddle her and I wasn't as exhausted.

Being a mother makes you feel guilty all the time regardless of what you do. But I've learnt one lesson. You can only do what you know best at the time, there's never a right or wrong thing to do.

Good luck with your decision.

[kashismum]

Seems you have a bit of a predicament.

If I were you, I would first check with a healthcare professional familiar with breastfeeding pharmacology. A lot of doctors and drug companies advise against breastfeeding when taking certain drugs without a complete understanding; they'd rather be safe than sorry.

Dr Hale is an expert - you could search his site at http://neonatal.ttuhsc.edu/lact/medi...orumspage.html

Again, ask if you absolutely MUST give up bf to have the jabs.

Otherwise, are you sure you are willing to put yourself through this? Pumping is always hard work, not to mention boring. Sustaining milk supply is always a problem. There's always the risk that you will not be able to/not want to re-establish breastfeeding.

Is taking the baby with you not an option? That would be the easiest solution by far!!

Whatever you decide, do so as a well-informed mother and not under pressure from others.

[LLL_Sarah]

I have looked up the two vaccines you mention in the book, Medications and Mothers' Milk by Dr. Thomas Hale. (This is THE book about taking drugs while breastfeeding.)

Hepatitis A Vaccine (page 428 – 12th edition)

Hepatitis A vaccine is an inactivated, noninfectious viral vaccination for Hepatitis A. Although there are no specific data on the use of Hepatitis A vaccine in breastfeeding women, Hepatitis A vaccine can be used in pregnant women after 14 weeks and in children 2 years of age. There is little likelihood that Hepatitis A vaccinations in breastfeeding women would cause untoward effects in breastfed infants.

Lactation Risk = L2 = SAFER

Typhoid Vaccine (page 884 – 12th edition)

Typhoid vaccine promotes active immunity to typhoid fever. It is available in oral form (Ty21a) which is a live attenuated vaccine for oral administration. The parenteral (injectable) form is derived from acetone-treated killed and dried bacteria, phenol-inactive bacteria, or a special capsular polysaccharide vaccine extracted from killed S. typhi Ty21a strains. Due to a limited lipopolysaccharide coating, the Ty21a strains are limited in their ability to produce infection.

No data are available on its transfer into human milk. If immunization is required, a killed species would be preferred, as infection of the neonate is possible.

Lactation Risk (injectable) = L2 = SAFER

There are 5 lactation risks in the book:
L1 = SAFEST
L2 = SAFER
L3 = MODERATELY SAFE
L4 = POSSIBLY HAZARDOUS
L5 = CONTRAINDICATED

L2 = SAFER = Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant. And/or, the evidence of a demonstrated risk which is likely to follow use of this mediation in a breastfeeding woman is remote.

Often doctors don’t use the Hale book (as they have to buy it!) but instead use a book published by the drug companies (which is given to them). The drug company books often say that medications are not advisable when pregnant or breastfeeding. This is a way for the pharmaceutical companies to protect themselves against law suits (especially law suits from the USA). But in their own protection they don’t worry about adverting mother to stop breastfeeding when they didn’t need to.

I can also look up the anti-malarial drugs if you can give me their medical names.

Best wishes,
SARAH

[jools]

Please contact La Leche League, they are experts on breastfeeding and as this is an unusual situation they would be the best people to talk to. If they personally haven't heard of a similar case they have a complete network of people who would be able to help. They also have the most up to date information about the affects of medications on breast milk.
Maggie 2817 7475
Margarita 2257 6757
Rochelle 2947 7147
Sarah 2548 7636

LLLHK@hotmail.com

Good luck

[carang]

sarah IS a leader at LLL....

[jools]

Sorry cara I know. When I entered my post her response wasn't there, so we must have been typing at the same time.