Episode Chapters
- Proctalgia Fugax13:22Knee X-Rays15:42Paper Chase #1 - Oseltamivir vs Usual Care in ILI6:30Peritoneal Dialysis, Part 1Free Chapter19:55Telling Pain Syndromes Apart14:40Paper Chase #2 - Unnecessary Pelvic Exams and Pap Smears7:27Peritoneal Dialysis, Part 218:09Alcohol Use in Pregnancy9:44Paper Chase #3 - Alcohol Abstinence in Drinkers with Atrial Fibrillation5:28Ode to the Node: Pediatric Lymphadenopathy27:10Scribes in Health Care20:34Paper Chase #4 - Effectiveness of Different Treatments for Opioid Use Disorder7:19The Breast Exam21:49Paper Chase #5 - Vit D and Calcium for Fracture Prevention8:24Mailbag12:50
When PC RAP listener David wrote to us that he has seen more of his patients using alcohol in pregnancy, our own Michael Baca-Atlas put on his addiction medicine hat to review research and recommendations regarding alcohol use in pregnancy.
Primary Care RAP Written Summary May 2020 981 KB - PDF
jkone10 - September 23, 2020 10:57 AM
It's also important to discuss how to manage breastfeeding with alcohol intake. In my personal and professional experience, I learned that "pump and dump" is often unnecessary and does not reduce alcohol content of breast milk more quickly than waiting. Waiting it out is the only safe course after alcohol consumption for breastfeeding moms. Pumping may be necessary to maintain supply during/after drinking, especially early post-partum and during baby's growth spurts so counseling patients on when to discard breast milk can also be an important topic.
https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html
Neda F., MD - September 29, 2020 12:03 PM
Thank you jkone10 for bringing up this important issue how alcohol use can impact maternal child healthcare specifically with regard to breastfeeding. In addition, higher levels of alcohol consumption can interfere with the milk ejection reflex (letdown) and overtime may lead to reduced breastfeeding duration due to decreased milk production. Excessive alcohol use while breastfeeding can also impact infant's sleep patterns which may worsen mom's sleep quality (both from alcohol and a non-sleeping newborn). To your point about "pump and dump," breast milk continues to contain alcohol as long as it remains in mom's bloodstream.
Thanks,
Michael