Breastfeeding and medications

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Breastfeeding and medications is the description of the

medications that can be used by a breastfeeding mother, and the balance between maternal health and the safety of the breastfeeding infant.[1][2] Medications, when administered to breastfeeding mothers, almost always are transferred to breast milk, albeit usually in small quantities.[3]
The degree of impact on the nursing infant varies, with many medications posing minimal risk. Nonetheless, informed decision-making and professional guidance is needed.

The

chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate.[4]

Some medications and herbal supplements can be of concern. This can be because the drug can accumulate in breastmilk or have effects on the infant and the mother. Those medications of concern are those medications used to treat substance and alcohol addiction. Other medications of concern are those that are used in

antidepressants need evaluation.[5]

Evaluating the potential for adverse effects

The determination of the safety of a medication can be evaluated by considering the following:

Lactation risk categories

Drugs can be categorised in one of five categories to determine how safe they are for breastfeeding:[6][7][8][9]

L1 Compatible

"Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant. Controlled studies in breastfeeding women fail to demonstrate a risk to the infant and the possibility of harm to the breastfeeding infant is remote; or the product is not orally bioavailable in an infant."[6]

L2 Probably Compatible

"Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant. And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote."[6]

L3 Probably Compatible

"There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant. (New medications that have absolutely no published data are automatically categorized in this category, regardless of how safe they may be.)"[6]

L4 Possibly Hazardous

"There is positive evidence of risk to a breastfed infant or to breastmilk production, but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant (e.g. if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective)."[6]

L5 Hazardous

"Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience, or it is a medication that has a high risk of causing significant damage to an infant. The risk of using the drug in breastfeeding women clearly outweighs any possible benefit from breastfeeding. The drug is contraindicated in women who are breastfeeding an infant."[6]

Over the counter medications

Over the counter medications are those medications that do not require a prescription
to purchase in the US. Medications that require a prescription to purchase in the US may be available in other countries without a prescription. The following guidelines are recommended:

Other substances or chemicals have been evaluated regarding their safe use during pregnancy. Hair dye or solutions used for a 'permanent' do not pass to breastmilk. No adverse reports of using oral antihistamines and breastfeeding are found. Some of the older antihistamines used by a nursing mother can cause drowsiness in the infant. This may be a concern if the infant misses feedings by sleeping instead of nursing.[11]

References

  1. ^ a b "The La Leche League InternationalI - Medications and Breastfeeding". La leche League International. Retrieved 2 August 2017.
  2. ^
    PMID 11456429
    .
  3. ^ "Breastfeeding" (PDF). Office on Women's Health, U.S. Department of Health and Human Services. 2014. Archived from the original (PDF) on 14 May 2017. Retrieved 20 July 2017.Public Domain This article incorporates text from this source, which is in the public domain.
  4. ^ Drugs and Lactation Database (LactMed). 2006. {{cite book}}: |website= ignored (help)Public Domain This article incorporates text from this source, which is in the public domain.
  5. ^ "Breastfeeding and Medication". American Association of Pediatrics. Archived from the original on 2 April 2019. Retrieved 4 August 2017.
  6. ^
    ISBN 9780826128584. ASIN 0826128580
    .
  7. ^ "Medications and Mothers Milk Online". www.medsmilk.com. Archived from the original on 2018-01-23. Retrieved 2018-03-24.
  8. ^ "Lactation Drug Risk Categories". CMBC Medical Reference. Retrieved 2018-03-24.
  9. ISBN 9780763745851
    .
  10. ^ staff, familydoctor.org editorial (1 September 2005). "OTC Medicines and Pregnancy - familydoctor.org".
  11. ^ "Drugs in Breastmilk -Is It Safe?". The Breasfeeding Network - Britains Nonprofit Breastfeeding Support Organization. Archived from the original on 7 January 2023. Retrieved 4 August 2017.

External links

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