Last update May 2, 2024

Maternal High blood pressure, HBP (hypertension, HTN)

Compatible

Safe product and/or breastfeeding is the best option.

Uncontrolled High blood pressure (HBP, HyperTensioN, HTN)) during pregnancy increases the incidence of prematurity and intrauterine malnutrition, which can give problems in the establishment of breastfeeding. (Lawrence 2016 p.565) 

Maternal HBP is compatible with breastfeeding and does not contraindicate it, but the other way around:

  • There is no difference in sodium and potassium content in colostrum from mothers with and without HTN. (Sírio 2007)
  • Breastfeeding can be therapeutic for maternal HBP. Prolactin is relaxing for the mother and the breast is an excretory organ that produces about one liter per day, so diuretics should be prescribed at lower doses. (Countouris 2016, Lawrence 2016 p.595) 
  • Breastfeeding decreases maternal risk of developing HBP and cardiovascular disease/metabolic syndrome (Pathirana 2023, Farahmand 2023, Park 2018, Zhang 2015, Lupton 2013, Stuebe 2011, Schwarz 2009). Breastfeeding could reduce the risk of pre-eclampsia in the next pregnancy (Adam 2021) and that of maternal type 2 diabetes and obesity. (Horta 2019 and 2015)

Treatment of HBP

A healthy, low-salt diet and exercise are fundamental in the prevention and treatment of HTN. 

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 groups of antihypertensives there are one or more of them that are considered compatible with breastfeeding: hydralazine and methyldopa; labetalol and propranolol; diltiazem, nifedipine and verapamil; captopril and enalapril are among them. (Ghelfi 2021, Anderson 2018, Malachias 2016)

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Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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.

Other names

Maternal High blood pressure, HBP (hypertension, HTN) in other languages or writings:

Group

Maternal High blood pressure, HBP (hypertension, HTN) belongs to this group or family:

References

  1. Farahmand M, Rahmati M, Azizi F, Ramezani Tehrani F. Lactation duration and lifetime progression to metabolic syndrome in women according to their history of gestational diabetes: a prospective longitudinal community-based cohort study. J Transl Med. 2023 Mar 6;21(1):177. Abstract Full text (link to original source)
  2. Pathirana MM, Andraweera PH, Aldridge E, Harrison M, Harrison J, Leemaqz S, Arstall MA, Dekker GA, Roberts CT. The association of breast feeding for at least six months with hemodynamic and metabolic health of women and their children aged three years: an observational cohort study. Int Breastfeed J. 2023 Jul 19;18(1):35. Abstract Full text (link to original source)
  3. Ghelfi AM, Ferretti MV, Staffieri GJ. Tratamiento farmacológico de la hipertensión arterial no severa durante el embarazo, el posparto y la lactancia. [Pharmacological treatment of non-severe hypertension during pregnancy, postpartum and breastfeeding]. Hipertens Riesgo Vasc. 2021 Feb 22. pii: S1889-1837(21)00013-1. Abstract
  4. Adam I, Rayis DA, ALhabardi NA, Ahmed ABA, Sharif ME, Elbashir MI. Association between breastfeeding and preeclampsia in parous women: a case -control study. Int Breastfeed J. 2021 Jun 29;16(1):48. Abstract Full text (link to original source)
  5. Horta BL, de Lima NP. Breastfeeding and Type 2 Diabetes: Systematic Review and Meta-Analysis. Curr Diab Rep. 2019 Jan 14;19(1):1. Abstract
  6. Park S, Choi NK. Breastfeeding and Maternal Hypertension. Am J Hypertens. 2018 Abstract
  7. Anderson PO. Treating Hypertension During Breastfeeding. Breastfeed Med. 2018 Abstract
  8. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  9. 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)
  10. 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 Full text (link to original source)
  11. Horta BL, Loret de Mola C, Victora CG. Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis. Acta Paediatr. 2015 Dec;104(467):30-7. Abstract
  12. 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 Full text (link to original source)
  13. Lupton SJ, Chiu CL, Lujic S, Hennessy A, Lind JM. Association between parity and breastfeeding with maternal high blood pressure. Am J Obstet Gynecol. 2013 Jun;208(6):454.e1-7. Abstract
  14. 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 Full text (link to original source)
  15. 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 Full text (link to original source)
  16. 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)
  17. Sírio MA, Silva ME, Paula Hd, Passos MC, Souza Sobrinho AO. Estudo dos determinantes clínicos e epidemiológicos das concentrações de sódio e potássio no colostro de nutrizes hipertensas e normotensas. [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 Full text (link to original source)

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