Last update: Aug. 17, 2019

Maternal Arterial Hypertension

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

Arterial hypertension (AH) which is uncontrolled during pregnancy increases the incidence of prematurity and intrauterine malnutrition, which can lead to problems in the establishment of breastfeeding (Lawrence 2016 p.565).

There are no differences in the sodium and potassium content in the colostrum of mothers with AH and without AH (Sírio 2007).

Breastfeeding may be therapeutic for maternal AH. Prolactin is a relaxant for the mother and the breast is an organ of excretion that produces about a litre a day, so diuretics should be prescribed at a lower dose (Countouris 2016, Lawrence 2016 p.595).

A healthy diet, low in salt, and exercise are essential in the prevention and treatment of hypertension.
Pharmacological treatment of hypertension includes diuretics and antihypertensives.
Among diuretics, acetazolamide, chlorothiazide, hydrochlorothiazide, and spironolactone are minimally excreted in milk and are compatible with breastfeeding (Malachias 2016, Lawrence 2016 p.595).
In almost all therapeutic antihypertensive groups there is one or more which are considered compatible with breastfeeding: hydralazine and methyldopa; labetalol and propranolol; diltiazem, nifedipine and verapamil; captopril and enalapril are some of them (Anderson 2018, Malachias 2016).

Breastfeeding decreases maternal risk of developing hypertension and cardiovascular disease (Park 2018, Zhang 2015, Stuebe 2011, Schwarz 2009).


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Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

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References

  1. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  2. Park S, Choi NK. Breastfeeding and Maternal Hypertension. Am J Hypertens. 2018 Abstract
  3. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  4. Countouris ME, Schwarz EB, Rossiter BC, Althouse AD, Berlacher KL, Jeyabalan A, Catov JM. Effects of lactation on postpartum blood pressure among women with gestational hypertension and preeclampsia. Am J Obstet Gynecol. 2016 Abstract
  5. Malachias MV, Figueiredo CE, Sass N, Antonello IC, Torloni MR, Bortolotto MRF L. 7th Brazilian Guideline of Arterial Hypertension: Chapter 9 - Arterial Hypertension in pregnancy Arq Bras Cardiol. 2016 Abstract Full text (link to original source) Full text (in our servers)
  6. Zhang BZ, Zhang HY, Liu HH, Li HJ, Wang JS. Breastfeeding and maternal hypertension and diabetes: a population-based cross-sectional study. Breastfeed Med. 2015 Abstract
  7. Stuebe AM, Schwarz EB, Grewen K, Rich-Edwards JW, Michels KB, Foster EM, Curhan G, Forman J. Duration of lactation and incidence of maternal hypertension: a longitudinal cohort study. Am J Epidemiol. 2011 Abstract
  8. Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, Cauley JA. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009 Abstract
  9. Ghanem FA, Movahed A. Use of antihypertensive drugs during pregnancy and lactation. Cardiovasc Ther. 2008 Abstract Full text (link to original source) Full text (in our servers)
  10. Sírio MA, Silva ME, Paula Hd, Passos MC, Souza Sobrinho AO. [Clinical and epidemiological determinants of sodium and potassium levels in the colostrum of breastfeeding mothers with and without hypertension in Brazil]. Cad Saude Publica. 2007 Abstract

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