FEATURE
few years ago, when my firstborn was seven months old, I developed an incredibly itchy rash on the back of my legs. Soon, red blisters extended over the back side of my body, covering me neck- to-toe. It wasn’t easy to get my condition A BY MARÍA JOSÉ DURÁN diagnosed. In fact, I still don’t know for sure what ails me. Physicians and dermatologists I consulted all shrugged with a look of pity in their eyes, o ff ering a shot of corticosteroids with some antihistamines. Until I told them I was breastfeeding. Then they walked back their recommendations, changed medications, and advised me to take lower doses. With just a topical steroid and an over-the-counter dose of Benadryl, my rash took months to clear. I wasn’t alone in this confusing medical purgatory. According to a 2017 study, more than 70 percent of women who breastfeed or pump their milk take some form of medication during lactation. Yet, a lack of research on the e ff ects, dosing, and safety of medications remains a real issue for those who breastfeed—and for their babies. “The majority of [medications] are not tested in the maternal-infant space,” says Lars Bode, director of the Human Milk Institute (HMI), a UC San Diego–based institution recently created to fill that gap. “That puts us in this dilemma. We have hardly any information about many [medications] out there that we know moms take.” A first-of-its-kind scientific collective in San Diego is working to understand the relationship between breast milk and medication Feeding it Forward
As a tandem-breastfeeding mother of two, both under four years old, I wanted to find out why it’s so hard to identify what medication is okay to use while lactating. Studies have proven that breastfeeding is good for babies and good for parents (although not the only option to raise a healthy baby). But so far, the biological composition of breast milk and its extensive benefits have been widely understudied. HMI gathers an array of pre-existing institutions within the UC San Diego campus, combining their individual e ff orts to expand our understanding of human milk. One of them, Mommy’s Milk Human Milk Research Biorepository, is the first-ever research database of human breast milk. Another, the Center for Community Health, seeks to improve lactation accommodation and equity. The University of California Health Milk Bank is one of only 31 nonprofit milk banks in North America, and the Larsson-Rosenquist Foundation Mother- Milk-Infant Center of Researcher Excellence focuses on better understanding the components of human milk. The Lactation and Perinatal Education Program at UC San Diego Extended Studies o ff ers clinical lactation education to professionals. “This is something we need to tackle from all kinds of di ff erent angles and disciplines,” Bode adds. He believes that San Diego is setting a global example in the field of breastfeeding. “We have a community that’s very passionate [about lactation research] and the clinicians, researchers, and educators that, for years, have done this [work] in their own way,” he says. Milk and Medicine In 2018, the Federal Task Force on Research Specific to Pregnant Women and Lactating Women recommended the then-secretary of the Department of Health and Human Services identify and address these gaps in knowledge. “To date, exclusion [of pregnant and breastfeeding people from research] may be motivated by concern about the possible harms of medication use during pregnancy or lactation,” reads the task force’s report. Their last meeting was in 2020. After this e ff ort died down, a bill was introduced to Congress in 2022 to try to revitalize it, but it’s had little success so far. That’s where Mommy’s Milk Human Milk Research Biorepository—part of HMI’s research arm—comes in. This lab collects milk samples from lactating people who are already taking medication in hopes they will amass enough samples to be able to produce a study. “We were established 10 years ago with the idea that we needed [more research on the e ff ects of medicine on pregnant and lactating people], and it’s not that di ffi cult to get it,” Mommy’s Milk director Christina Chambers says. “It’s just [about having] the will and the resources to do it.”
72 OCTOBER 2023
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