Mum & Children

Medication Use During Pregnancy

Pregnancy is a special physiological condition where the use of medication presents a special concern as the medication may reach the foetus and cause harm. However, total avoidance of medication in pregnancy may not be possible and could be dangerous. Any medicine taken during pregnancy should be used at the lowest effective dose for the shortest possible time.

Tips for medication use during pregnancy

  • Never start or stop taking medication before consulting your doctor
  • Keep a record of the medication taken during pregnancy or when you are expecting
  • Never share your medications
  • Do not skip your medication as it may be more harmful to the mother and the foetus
  • When in doubt, consult your doctor or pharmacist about the benefits and risks of the medication

Breastfeeding and Medication

Concerns on Breastfeeding and Maternal Medication Use

Some medication can pass into the breast milk. The amount transferred into the breast milk depends on many factors, including the chemical properties of the medication.

In general, there are very few medications that are absolutely contraindicated during breastfeeding. These medications that present in breast milk may pose risks to the baby while some can affect the supply and composition of the breast milk.

What is “Pump and Dump”?

The “pump and dump” method involves expressing and disposing of the breast milk. It is recommended that this technique be used until at least 3 hours after the last intake of the medicine that is not suitable for use when breastfeeding.

Benefits of this method:-

  • Relieves breast fullness or engorgement
  • Ensuring breast milk supply

Common Medications Safe for Use during Breastfeeding

Types of Medication
Medication Name
Pain Killers
Paracetamol, Ibuprofen, Diclofenac
Cough and Cold
Bromhexine, Pholcodeine, Dextromethorphan
Oral Contraceptive
Progesterone only pills
Allergy and hayfever
Loratadine, Desloratadine, Fexofenadine

Common Medications Safe for Use during Breastfeeding

Your pharmacist will be able to provide advice on the suitability of your medication and timing to take the medication while breastfeeding, if your medication is safe for your baby or if it may affect your milk supply.

Possible medication timing for consideration:-

  • Immediately after feeding the baby
  • Before the baby’s longest sleep period
  • After baby’s last feed for the day

BabyCenter. (2017). Drug safety while breastfeeding | BabyCenter. [online] Available at: [Accessed 3 Sep. 2017].
Helms, S. and Darbishire, P. (2009). Understanding Breastfeeding: Beyond Medication. US Pharm, 34(9), pp.25-33. Verywell. (2017). When to Use the Pump and Dump Method for Lactation. [online] Available at: [Accessed 3 Sep. 2017].

Probiotics in Paediatrics

Definition of Probiotics?

Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.

How Do They Work?

  • Probiotics are good bacteria that inhibit the growth of bad bacteria, promote good digestion, reduce toxins, and boost your immune system
  • Keeping a ratio of more good bacteria is crucial in staying healthy

Probiotics in Food & Supplements

  • Yogurt, sauerkraut, cheese, kimchi, tempeh, miso and natto are some foods that contain probiotics
  • Also available in supplements in the form of millions of bacteria cultures
    (often referred as CFUs – Colony Forming Units)

Prevention & Treatment in Diseases

  • Acute infectious diarrhoea
  • Antibiotic induced diarrhoea
  • Treatment and prevention of atopic disease
  • Ulcerative colitis
  • Irritable bowel syndrome
  • Necrotizing enterocolitis


  1. World Gastroenterology Organisation Global Guideline - Probiotics and Prebiotics 2017.
  2. Lippincott Williams & Wilkins. Clinical Efficacy of Probiotics: Review of the Evidence with Focus on Children. Journal of Pediatic Gastroenterology and Nutrition. 43:550-557. October 2006
  3. Dan W.Thomas ET AL. American Academy of Paediatics. Clinical Report - Probiotics and Prebiotics. Volume 126, Number 6. December 2010.

FAQ on Probiotics

What does CFU mean?
CFU stands for “colony forming units” and is used to quantify how many bacteria in probiotics are capable of dividing and forming colonies.

Does more CFU mean better?
The dose needed for probiotics varies greatly depending on the strain and product although many are in the range of 1–10 billion CFU per dose.

Do probiotics have side effects?
Side effects are typically mild, temporary and often a sign that the probiotics are working and are often part of the natural cleansing process, for example, minor constipation, mild diarrhoea, mild rash, cramps, and gas.

How long do I need to take probiotics?
It is recommended to take probiotics daily between 2 weeks to 2 months to fully re-colonize the bowel’s healthy bacteria.

Are probiotic supplements safe for pregnant or nursing mothers?
Probiotic supplementation during pregnancy improves newborn’s immunity and decreases allergies. For nursing infants, immunity and allergy improvements have also been observed. Always check with your doctor or pharmacist to confirm that any supplement, including probiotics, are safe for use during pregnancy and breastfeeding.

World Gastroenterology Organisation Global Guideline – Probiotics and Prebiotics 2017
Patient handout. University of Wisconsin Integrative Medicine

Allergic Rhinitis in Children:
A Sneezing Dilemma

Common cold
Allergic Rhinitis
Allergen (pollen, mold, dust mites, cigarette smoke, pet dander)
Runny nose, blocked nose, sneezing
Chronic runny nose, blocked nose, sneezing with itchy eyes and ears

Allergic rhinitis can affect school work and sports performance

  • The nasal congestion caused by allergic rhinitis may affect the child’s quality of sleep. This would affect their concentration the following day
  • As the child’s breathing quality is affected, their ability to exercise and play sports is also compromised

What are the management strategies for allergic rhinitis?

Besides seeking medical attention, the first approach is to identify the triggers and minimize exposure.

Outdoor exposure

  • Wear mask and glasses
  • Avoid hanging clothes outside

Indoor exposure

  • Mites – use “mite-proof” covers, wash linens and curtains with hot water
  • Mould – use dehumidifier

Pet dander exposure

  • Wash hands after petting animals
  • Keep pets outside

Nasal irrigation is used to rinse off the allergens and is effective in approximately 50% of patients with allergic rhinitis.


Lactose Intolerance in Children

What is Lactose Intolerance?

Lactose intolerance is when the body cannot digest lactose which results in gastrointestinal symptoms.

What causes lactose intolerance?

  • It occurs when the small intestines do not produce enough lactase (enzyme) to digest lactose (milk sugar). Lactose is then fermented by bacteria and produces unpleasant symptoms
  • Lactose intolerance in children is often caused by an infection in the digestive system, and will only last a few weeks

What are the symptoms of lactose intolerance?

Symptoms of lactose intolerance usually occur within 30 minutes to 2 hours after lactose consumption and includes:

Lactose Intolerance in Children


Lactose Intolerance in Children

Nausea and Vomiting

Lactose Intolerance in Children


Lactose Intolerance in Children

Abdominal Pain and Cramps

Lactose Intolerance in Children

Flatulence (Wind)

What types of food contain lactose?

  • Lactose is the natural sugar found in the milk of mammals such as cows, goats and sheep
  • Dairy products such as cheese, ice cream, butter and yoghurt may contain lactose

How is lactose intolerance managed?

  • There is no cure for lactose intolerance. However, symptoms can be reduced by making changes to diet
  • Serve small servings of milk and dairy products in regular meals
  • For babies with lactose intolerance, lactose-free formula milk is available in pharmacies and supermarkets
  • Probiotics may help in the management of lactose intolerance

Is lactose intolerance the same as milk allergy?

No. They may share similar symptoms but are entirely different conditions

Lactose Intolerance
Milk Allergy
A sensitivity
An allergy
Occurs in gastrointestinal system
Triggered by immune system
A sensitivity to milk carbohydrate (lactose)
A reaction to milk protein
Rare in young children
Generally impacts young children
(may be outgrown)
Can enjoy milk and milk products with simple management strategies
Should avoid milk and milk products
(unless allergy is outgrown)