When a breastfeeding mother has to undergo a medical procedure such as a colonoscopy, she might be wondering if the medications used during the procedure are safe for her baby and when she can continue breastfeeding normally. Breastfeeding mothers who must have colonoscopies can expect to continue their nursing relationship with some advance preparation.
Colonoscopies are given to examine the colon and part of the bowel for a variety of reasons. Doctors might want to diagnose or remove lesions or polyps. The procedure is done to diagnose inflammatory bowel disease or diverticulitis. Colonoscopies are also used to screen for colon cancer in older patients, or those with a history of colon cancer in their family.
The procedure requires that the colon is free of fecal matter. Patients are asked to drink a clear liquid diet with little fiber ingestion for one to three days prior to the procedure. On mothering.com, pediatrician Bob Sears says that even though some doctors suggest not nursing during the preparation period, it’s safe to nurse up until the time of the colonoscopy. After the procedure, mothers can nurse their babies once their sedative has worn off and they’re able to pump their breastmilk once and dispose of it. Mothers should speak with their doctors to determine if the drugs they’re given before the procedure are, in fact, compatible with breastfeeding.
The Breastfeeding Network suggests that mothers have someone with them in the days before the procedure and a day after the procedure to make sure that they are staying fully hydrated during this time. Lack of nutrients could result in a drop of milk supply, so the breastfeeding mother should be encouraged to drink ample water and other liquids. Also, the breastfeeding mother might be extra tired from ingesting fewer calories, so she may need help caring for her baby.
The Breastfeeding Network says that the typical laxative used to prepare the bowels for a colonoscopy—picosulphate or osmotic laxative macrogal 3350—are not contraindicated for breastfeeding, so mothers should be able to take these and still continue to breastfeed. These laxatives are not absorbed into breastmilk, and pass through the gut without being absorbed into the body.
During the procedure, patients are given a short-acting hypnotic like midazolam to help sedate and make them comfortable. This drug is not contraindicated during breastfeeding, the Breastfeeding Network says, unless the mother is breastfeeding a baby at risk for respiratory depression.
Mothers, however, should speak with their doctors to determine the safety of their specific medications. Breastfeeding mothers might also find it helpful to speak to a lactation consultant who can provide alternative medication suggestions, if necessary.
During the recovery period, the breastfeeding mother might find that she’s tired or feels a bit off from the hypnotic drugs. Caregivers can assist the breastfeeding mother during this time. “The Breastfeeding Answer Book” says that because the breastfeeding relationship is a supply and demand one, the nursing mother should make sure she does what she can to maintain her milk supply. Caregivers can help position the baby during a feeding to make sure the mother is able to continue her breastfeeding relationship.