Written by pharmacy student Serabi Rembert, Merer University, College of Pharmacy, Class of 2021

 

The National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention (CDC) provided data on numbers and characteristics of births in 2018. The largest number of births occurred in the month of August according to the National Vital Statistics Reports (NVSS) published on November 27, 2019.2

 

National Vital Statistics Reports (NVSS

Table I–2. Births, and seasonally adjusted birth rates, by month: the United States, 2018.2

 

Breastfeeding is a vital source that provides essential nutrition for most infants.3 Human milk allows the infant to obtain the proteins, fats, carbohydrates, sugars, as well as, vitamins which contribute to healthy development.4 The milk of a mother is uniquely suited for her child(ren) and is known as the biological norm that creates and builds an infant’s immune system with defenses such as antibodies, immune factors, different enzymes, and [white blood cells].5

“Breastfeeding provides unmatched health benefits for babies and mothers. It is the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. We must do more to create supportive and safe environments for mothers who choose to breastfeed.”

Dr. Ruth Petersen, Director of CDC’s Division of Nutrition, Physical Activity, and Obesity

 

According to the 2018 CDC Breastfeeding Report Card, 4 out of 5 (83.2%) of mothers living in the U.S. start out breastfeeding [at 6 months] in 2015.6

How Breastfeeding Mothers Need SupportFigure 3. CDC’s Work To Support & Promote Breastfeeding In Hospitals, Worksites, & Communities7

 

Among the infants born in 2015 in the U.S. over half (57.6%) were breastfed at 6 months, and over one-third (35.9%) were breastfed at 12 months.6 Among African-American babies, the rates are significantly lower with a 15% less likely chance of being breastfed.7 There are many mothers in the U.S. who wish to start and continue with breastfeeding; however, these rates uncover the issue which is lack of support.

“Given the importance of breastfeeding on the health of mothers and children, it is critical that we take action to support breastfeeding. Only through the support of family, communities, clinicians, healthcare systems, and employers will we be able to make breastfeeding the easy choice.”

 

Dr. Jerome M. Adams, U.S. Surgeon General

The new mothers of this need our support, and The Surgeon General’s Call to Action to Support Breastfeeding will help all of us see how we all can cheerfully and regularly minimize some of the issues/dilemmas that may prevent or affect women who wish to breastfeed.

 

Common Issues and Dilemmas Plaguing Women Trying To Breastfeed8

  • Lack of experience or familial support [for mothers and babies]
  • Lack of opportunities to discuss the experience with breastfeeding mothers
  • Lack of relevant and up-to-date instruction and information from healthcare professionals
  • Lack of accommodation at work & efficient start on breastfeeding in hospital practices

Read more about breastfeeding and CDC initiatives to further educate the public and advocate actively for mothers and infants, and more here.

 

The American Academy of Pediatrics (AAP) recommends that infants be exclusively breastfed around the first 6 months of life, as well as, there ought to be continued breastfeeding alongside the introduction of appropriate complementary foods for 1 year or longer.9 This maximizes physiological benefits for both the mother and baby.

 

Breastfeeding Benefits
Image Source: ACOG, 201610

 

In addition, infants who are breastfeed receive protection against diseases such as bacteremia, urinary tract infections, late-onset sepsis in preterm infants, childhood overweight and obesity, and various cancers. Breastfeeding also can help the mother with lactation amenorrhea11. You can find these benefits on the AAP website when you click this link. 

It serves great benefits to the environment and society as well. According to The Surgeon General’s Call to Action to Support Breastfeeding, families that proceed in optimal breastfeeding can save $1.200-$1,500 on infant formula in the first year alone. Thanks to benefits, infant health is likely better and that leads to breastfeeding families less likely being sick often as well as fewer health insurance claims and parents missing less work (so higher productivity)8. There is no worry of needing a manufactured product (i.e. Similac) or making waste or air pollution, AND the milk is always at the right temperature and ready to feed11

 

How Can We All Work to Support Breastfeeding Mothers? 

The Surgeon General’s 2011 Call to Action to Support Breastfeeding provides the following considerations8:

Healthcare Providers (HCPs)

  • Hospitals: Incorporate recommendations of UNICEF/WHO’s Baby-Friendly Hospital Initiative.
  • Provide breastfeeding education for health clinicians caring for women and children.
  • Ensure access to International Board Certified Lactation Consultants.

Employers

  • Start and maintain high-quality, lactation support programs for employees.
  • Provide clean places for mothers to breastfeed.
  • Establishing paid maternity leave for employed mothers.

Community Leaders

  • Strengthen programs giving mother-to-mother support and peer counseling.
  • Use community organizations to promote and support breastfeeding.

Family & Friends [of the mothers]

  • Give mothers support and encouragement needed to breastfeed.
  • Take advantage of programs to educate fathers and grandmothers about breastfeeding.

Policymakers

  • Support small nonprofit organizations that promote breastfeeding in African-American communities.
  • Support compliance with the International Code of Marketing of Breast-milk Substitutes.
  • Increase funding of high-quality research on breastfeeding.
  • Support better tracking of breastfeeding rates and factors that affect breastfeeding.

 

Breastfeeding and Medication Safety and Considerations12 


Mothers should NOT breastfeed or feed expressed breast milk to their infants if: 

  • Infant is diagnosed with classic galactosemia
  • Mother is infected with the human immunodeficiency virus (HIV)
  • Mother is using an illicit street drug
  • Mother has suspected or confirmed Ebola virus disease

 

Mothers should temporarily NOT breastfeed and should NOT feed expressed breast milk to their infants if: 

  • Mother is infected with untreated brucellosis
  • Mother is taking certain medications
  • The mother is undergoing diagnostic imaging with radiopharmaceuticals
  • Mother has an active herpes simplex virus (HSV) infection with lesions present on the breast

 

Mothers should temporarily NOT breastfeed, but CAN feed expressed breast milk if:

  • Mother has untreated, active tuberculosis
  • Mother has active varicella (chicken pox) infection that developed within the 5 days prior to delivery to the 2 days following delivery

 

Prescribing for Breastfeeding Mothers

 

When prescribing therapies to breastfeeding mothers, all healthcare providers are advised by the American Academy of Pediatric (AAP) to consider the following13:

  • The need for the drug by the mother
  • Potential adverse effects of the drug on the milk production
  • Amount of potential drug excretion into human milk
  • Age of infant
  • Number of feedings that are breast milk
  • Oral drug absorption by the infant
  • Potential adverse effects on the infant

 

Compounding: Addressing Unique Medication Needs14

Compounding is the creation of a pharmaceutical preparation, also known as a drug by a licensed pharmacist in order to address the unique needs of a patient (i.e., animal or human) when a commercially available drug is unable to meet those needs. It is a way to obtain medications in a situation where a patient may not be able to tolerate the commercially available drug, the preparation needed cannot be found/available commercially, or the medication that the patient needs is either in shortage, unknown or extended backorder or discontinued.

Based upon a prescriber’s prescription, the following can be done to meet a patient’s need:

  • Customize strength or dosage
  • Flavor a medication (making it more palatable for a child or a pet)
  • Reformulating the drug to not use unwanted or nonessential ingredients like lactose, gluten, or a dye (for which the patient is allergic to)
  • Can change the formulation of a medication
    - In the case of difficulty swallowing or the experience of stomach upset

Please note: compounding is NOT a commercially available drug duplicating service.

 

 

Compounded Medication Options for Moms

The pharmacists at Innovation Compounding are available to formulate medications for common conditions such as:

  • Nipple Ointment for Breastfeeding
  • Melasma ('Pregnancy Mask')
  • Eczema Flare-ups (pre and post-pregnancy)
  • Acne
  • Puffy Eye Treatments
  • Dermatitis
  • Hemorrhoids
  • Anal Fissures
  • Stretch Marks
  • Surgical Scars

 

Connect with Us

If you have any questions or would like additional information, please contact Innovation Compounding at 1-800-547-1399, Monday-Friday, 9 a.m. to 5 p.m. EST, excluding all major holidays.

Medical Disclaimer This content is for informational and educational purposes only. It is not intended to provide medical advice or take the place of such information or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Innovation Compounding, Inc. nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any medication, nutritional supplement, diet, or health regimen.


 

References

  1. The Conversation. U.S. support of formula over breastfeeding is a race issue [image]. https://theconversation.com/u-s-support-of-formula-over-breastfeeding-is-a-race-issue-99987. Published on July 23, 2018. Accessed on June 28, 2020. 

  2. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: Final data for 2018. National Vital Statistics Reports; vol 68, no 13. Hyattsville, MD: National Center for Health Statistics. 2019.

  3. Breastfeeding: About Breastfeeding. Centers for Disease Control and Prevention website. https://www.cdc.gov/breastfeeding/about-breastfeeding/index.html. Accessed on June 28, 2020.

  4. HealthyChildren from the American Academy of Pediatrics. Breastfeeding Benefits Your Baby's Immune System. HealthyChildren Website. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Breastfeeding-Benefits-Your-Babys-Immune-System.aspx. Updated on August 8, 2016. Accessed on June 29, 2020. 

  5. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013;60(1):49-74. doi:10.1016/j.pcl.2012.10.002

  6. Breastfeeding: Breastfeeding Report Card. United States, 2018. Centers for Disease Control and Prevention website. https://www.cdc.gov/breastfeeding/data/reportcard.htm. Last reviewed on December 31, 2019. Accessed on June 28, 2020.

  7. Breastfeeding: Why It Matters. CDC’s Work To Support & Promote Breastfeeding In Hospitals, Worksites, & Communities [Image]. Centers for Disease Control and Prevention website. https://www.cdc.gov/breastfeeding/pdf/breastfeeding-cdcs-work-508.pdf. Accessed on June 28, 2020.

  8. Breastfeeding: Surgeon General’s Call to Action Fact Sheet. United States Department of Health and Human Services website. https://www.hhs.gov/surgeongeneral/reports-and-publications/breastfeeding/factsheet/index.html. Last reviewed on January 19, 2011. Accessed on June 30, 2020. 

  9. Breastfeeding: Frequently Asked Questions (FAQs). Centers for Disease Control and Prevention website. https://www.cdc.gov/breastfeeding/faq/index.htm#benefits. Reviewed on May 28, 2020. Accessed on June 28, 2020.

  10. Beldico: Blog. Breastfeeding Benefits [image]. Beldico website. https://www.beldico.be/en/mermaid/blog/breastfeeding-benefits.html. Published on June 3, 2018. Accessed on June 29, 2020. 

  11. Breastfeeding: Benefits of Breastfeeding. American Academy of Pediatrics Website. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Breastfeeding/Pages/Benefits-of-Breastfeeding.aspx. Accessed on June 29, 2020.

  12. Davanzo R. Controversies in Breastfeeding. Front Pediatr. 2018;6:278. Published 2018 Nov 1. doi:10.3389/fped.2018.00278

  13. Breastfeeding and Certain Circumstances: Vaccinations, Medications, & Drugs.  Prescription Medication Use. Centers for Disease Control and Prevention website. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/prescription-medication-use.html. Reviewed on February 4, 2020. Accessed on June 28, 2020.

  14. American Pharmacists Association: Frequently Asked Questions About Pharmaceutical Compounding. American Pharmacists Association website. https://www.pharmacist.com/frequently-asked-questions-about-pharmaceutical-compounding. Accessed on June 28, 2020.

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