Basics of Lactation

Question 1

A drug deemed unsafe in pregnancy…

Safe in lactation?

Answer 1

Is not necessarily unsafe for breast/chestfeeding

Question 2

Some advantages of breastfeeding include…

Answer 2

Physical + emotional bonding
Nutritional benefit
Protective - GI infections, AOM, respiratory tract, SIDS
Enhanced cognitive development

Question 3

WHO recommends exclusive breastfeeding for…

Answer 3

The first 6 months

Question 4

Almost all drugs which reach systemic circulation will…

Answer 4

Enter human milk to some degree, but not likely at a level that is harmful (rarely will produce clinical doses in the infant)

However there is a chance of toxicity if drug enters milk in pharmacologic quantities… ultra-rapid 2D6 metabolizer + codeine

Question 5

Maintenance of milk supply requires…

Answer 5

Sufficient production
Effective extraction

Question 6

Factors that may contribute to insufficient milk production include..

Answer 6

Previous breast surgery
Poor initial feeding routines early postpartum
Incomplete drainage
Medications

Question 7

Some medications that may cause insufficient milk production include…

Answer 7

Bromocriptine
CHC’s - estrogen dose related
Anticholinergics, oral decongestants
Diuretics

Question 8

Ineffective milk extraction may be due to…

Answer 8

Poor technique
Poor initial feeding routines early postpartum
Abnormalities of nipple or infant’s mouth
Blocked ducts

Question 9

The two main considerations of drug use in lactation are…

Answer 9

The effect of drug exposure on infant via milk
The effect of drug on milk production