What are the recommendations for antihypertensive treatment during breastfeeding for women with hypertension in the postnatal period?
The NICE guideline on hypertension in adults recommends avoiding the use of diuretics or angiotensin receptor blockers to treat hypertension in women in the postnatal period who are breastfeeding or expressing milk. If blood pressure is not controlled with a single medicine, consider a combination of amlodipine and enalapril. If this combination is not tolerated or is ineffective, consider either adding atenolol or labetalol to the combination treatment or swapping one of the medicines already being used for atenolol or labetalol. For women of black African or Caribbean family origin with hypertension during the postnatal period, consider antihypertensive treatment with amlodipine if the woman has previously used this to successfully control her blood pressure.