Not only must women watch what they eat and drink during pregnancy and breastfeeding, they must also be mindful of the drugs they take to treat common and not-so-common illnesses. This is made even more challenging by the fact that very little research is available on the use of drugs during pregnancy and breastfeeding.
According to NPR, pregnant women have been excluded from medical research, because scientists and ethicists were concerned that experimenting on them could hurt them or their fetus.
Dr. Catherine Spong, chief of maternal-fetal medicine at the University of Texas Southwestern Medical Center in Dallas says when women are pregnant, their blood volume doubles and their liver and kidney function change. No one knows how that affects the medication.
So doctors across the country find themselves prescribing medications, or taking patients off them, without evidence based research to support their decisions either way.
By keeping pregnant women out of studies, Spong says, "You are putting them and their fetuses more at risk."
Spong was chair of a federal task force that studied the gaps in health care knowledge about pregnant and lactating women. The group issued a 388-page report in September that recommends that pregnant women be routinely included in research studies, that the government devote time and money to studying existing drugs in pregnant women and that the government help develop new drugs to treat problems related to pregnancy and breastfeeding.
Lactation Lab founder Dr. Stephanie Canale has seen the impact this lack of research can have. She is researching the effects the chemotherapy drug cisplatin can have on breast milk using the same technology she pioneered in her breast milk test kits. While patients are typically cleared to resume breastfeeding 72 hours after treatment with cisplatin, Dr. Canale found evidence of platinum in a chemotherapy patient's breast milk more than 100 days after her last treatment.
Cisplatin is a cytotoxic drug and prolonged excretion in human milk might have adverse effects on newborns if women are cleared to breastfeed too soon. “The side effects of the drug can seriously impact infant health. Women who have taken cisplatin should be very cautious about resuming breastfeeding before the drug has cleared their bodies,” says Dr Canale. “ We recommend waiting a minimum of 4-5 months after their last dose, or to have their milk tested prior to breast feeding their child.”