Breastfeeding: Pumping and dumping or weaning due to medication

I have to be on methylprednisolone tablets to control severe asthma for six days. During this time, my daughter's pediatrician does not want me to nurse her. He recommended that I wean or "pump and dump." I didn't want to wean but I am having a hard time relaxing when I express my milk. So far I am only able to pump three to four ounces at a time. I don't want my milk supply to be too badly affected. My daughter is almost four months old and is drinking six ounces at a feeding. What should I do?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

Actually there are very few medications that can not be used while breastfeeding. I am unsure why your daughter's pediatrician has advised you to temporarily stop nursing.

Methylprednisolone is the metabolized, or active form, of prednisone. The American Academy of Pediatrics (AAP) has approved prednisone for use in nursing mothers (AAP, Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 1994;93:137-150).

If you do decide to continue to express your milk and not feed it to your baby while you are on this medication, I would recommend that you pump as often as your baby would typically nurse. To best maintain your milk supply when your baby is not at your breast, use a hospital grade electric breastpump. The double pump kit will reduce the time you spend expressing your milk, and you may find that you are able to net more milk in the same amount of time.

Plan on spending 15 to 20 minutes expressing your milk at each session (if you are double pumping.) If you occasionally are unable to find the time to express for the time recommended, it is better to spend 5 or 10 minutes using the pump than not expressing your milk at all. Actually, the amount of milk you are expressing -- three to four ounces -- is quite within the normal range. Even the best breastpump will not be as good at extracting milk from your breasts as a baby who nurses effectively.

You may find it helpful to use warmth and massage just before, as well as during pumping. Hand expressing a bit of your milk before using the pump may also facilitate let-down. Once your milk ejects, you can then use the pump. This may help you to access more of your milk.

Temporary cessation of breastfeeding can negatively impact the breastfeeding relationship, and can lead to premature weaning. When considering the use of a medication by the nursing mother, it is important to keep in mind the risks of your baby not receiving mothers' milk, compared to the theoretical risk to your baby of using that particular drug. I would recommend discussing this issue with your care provider and your baby's care provider. If you are uncomfortable with their recommendation, don't hesitate to seek a second opinion. My best wishes for good health to you and your family!

 

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