Question

A lactating woman has developed thromboembolism. which drug should be prescribed if she wishes to continue breast-feeding?

Answer 1

The drugs which can be used are : Low molecular weight heparin, unfractionated heparin and Warfarin.

The risk of developing thrombi (thrombophlebitis) is increased for 6 to 8 weeks after delivery (thromboembolic disease during pregnancy). In general, these thrombi form in the deep veins of the lower limbs or pelvis (a condition called deep vein thrombosis).

Sometimes one of these thrombi breaks off and migrates into the bloodstream to the lungs, where it lodges in a vessel, blocking blood flow. This is a pulmonary embolism.

Thrombi can also form in the veins just below the skin of the lower limbs. This is referred to as superficial vein thrombosis (superficial thrombophlebitis).

For superficial thrombi: hot compresses, compression bandages and elevation of the affected limb.

For deep vein thrombosis or pulmonary embolism: medications.

The treatment of a superficial thrombus in the lower limbs involves the application of hot compresses (to reduce discomfort), the application of compression bandages by a doctor or a nurse and, at rest, the elevation of the affected leg (by example, raising the feet of the bed by 15 centimeters).

Women with deep vein thrombosis or pulmonary embolism should take medication to prevent blood from clotting (anticoagulants).

Answer 2

The U.S. National Institutes of Health has issued guidelines regarding the use of anticoagulants during breastfeeding. Specifically, warfarin, low molecular weight heparin, and unfractionated heparin are all considered to be safe for use with women who are lactating and breastfeeding, as these drugs have not been found to transmit into breast milk.