Weighing up the Risks

• Published in: Natural life (Unionville. 1991) p. 40
• Main Author: Curley, Pauline Mary
• Format: Magazine Article
• Language: English
• Published: Toronto Life Media 01-01-2009
• Subjects: Babies; Births; Breastfeeding & lactation; Mothers
• ISSN: 0701-8002

I was shocked and disappointed to discover that babies in the U.S. were routinely delivered by doctors, and not by midwives. Feeling alienated from the system and thinking I had no choice, Ireluctantly signed up with a local obstetric/gynecology practice. From the outset, I made my wishes clear to my doctor: I didn't want to be induced; I didn't want an epidural or any other pain medication; I didn't want an episiotomy; and I certainly didn't want to have my legs up in stirrups for delivery, as was routine in this hospital! [Ruth] and I began to explore other options. True, I needed medication to treat the DVT; that was not optional. What about "pumping and dumping" my milk for the duration of the medication and then resuming breastfeeding? But I would be on medication for at least three months - too long, I thought, to sustain my milk supply by trying to fool my body in this way. Anyway, even if I managed to do this, [Grace] would still be at the loss of her mother's milk for those important three months and our nursing relationship would be severely disrupted. So we ruled out that option. Coumadin was definitely contraindicated for nursing mothers. But what about the Heparin - would that really put my baby at risk? The following day dawned and a miracle unfolded. I cried with relief as the advice from both the lactation consultant and the pharmacist confirmed the information given to us by the nurse the previous night: Although there had not been any actual clinical trials carried out on nursing moms, apparently women on Heparin had nursed safely. According to the scientific evidence, the molecular size of Heparin is too large to allow it to cross into mother's milk. Even if some Heparin did get into the milk, the pharmacist explained, it would be destroyed by the baby herself during digestion, because for Heparin to take effect, it must be injected subcutaneously. So I could safely inject myself with the prescribed Heparin, secure in the knowledge that it was unlikely to get into my breast milk. And I was doubly reassured by the fact that any of the medication that did somehow get through would be destroyed by Grace's own digestive system. What a revelation! What a relief!