I have a permission to post. A mother of the first child is having a severe case of CRPS and have not been able to walk. The pain is affecting her whole body. Prior pregnancy she used Norspan (buprenorphine), Cymbalta (duloxetine), Topimax (topiramate) and Lyrica (pregabaline) to control the pain but all the medication has been stopped for pregnancy except Norspan 20mg (1 in 7 days). The c-section is going to be 15.2. and the mother have been discussing about her medication with the Finnish Teratologic Info Service (run by the Helsinki University Hospital). The Norspan has been said to be acceptable with the breastfeeding from the Info Service (The service is nationwide and highest information about medications during pregnancy and breastfeeding). Now some of the doctors are not happy with the medication and have said mother that she is not allowed to breastfeed.
What is the recommendation with Norspan while breastfeeding? How about the other medication the mother used prior pregnancy, is it possible to combine one or two of them to Norspan if needed while breastfeeding? The pregnancy eased her symptoms and she is managing with only Norspan for now on. She is very determined to breastfeed her child if it is considered safe with the medication she needs.
The baby is going to be admitted to Special Care Nursery for a day or two to see how she / he adapts and if the baby will need something treatment during neonatal period right after birth because of mother's medication. If breastfeeding is acceptable, what follow-up the baby would need? All Finnish babies have regular follow-up at well baby clinics so that would not be a problem.
On the other hand we have mothers with drug abuse who are in drug withdrawal therapy and they are using buprenorphine and other drugs to control symptoms and they are usually breastfeeding and breastfeeding is accepted by the hospital protocol.
I am happy to have any information!
Warmly,
Pia Ruohotie
RN, IBCLC
From Helsinki Finland
What is the recommendation with Norspan while breastfeeding? How about the other medication the mother used prior pregnancy, is it possible to combine one or two of them to Norspan if needed while breastfeeding? The pregnancy eased her symptoms and she is managing with only Norspan for now on. She is very determined to breastfeed her child if it is considered safe with the medication she needs.
The baby is going to be admitted to Special Care Nursery for a day or two to see how she / he adapts and if the baby will need something treatment during neonatal period right after birth because of mother's medication. If breastfeeding is acceptable, what follow-up the baby would need? All Finnish babies have regular follow-up at well baby clinics so that would not be a problem.
On the other hand we have mothers with drug abuse who are in drug withdrawal therapy and they are using buprenorphine and other drugs to control symptoms and they are usually breastfeeding and breastfeeding is accepted by the hospital protocol.
I am happy to have any information!
Warmly,
Pia Ruohotie
RN, IBCLC
From Helsinki Finland
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