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MY REVISION - PSA > BREASTFEEDING > Flashcards

BREASTFEEDING Flashcards

1
Q

BREASTFEEDING
how long should infants be exclusively breastfed for?

A

6 months

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2
Q

BREASTFEEDING
what are the risks for the infant if they are not breastfed?

A

increased risk of:
- asthma + atopic illness
- D+V
- necrotising enterocolitis (NEC)
- obesity + CVD later in life
- otitis media, Hib meningitis, UTIs
- sudden infant death syndrome
- T1DM + T2DM

also increases IQ

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3
Q

BREASTFEEDING
what are the risks to the mother if not breastfeeding?

A

increased risk of:
- breast + ovarian cancer
- CVD
- obesity
- osteoporosis
- postnatal depression
- post-partum haemorrhage
- T2DM

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4
Q

PHARMACOLOGY
what things should you consider when prescribing in breastfeeding?

A
  • age of the baby (hepatic + renal function improve after a few weeks of life)
  • whether baby has co-morbidities
  • whether mother is taking medications + what it is
  • how often baby is breastfed
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5
Q

PHARMACOLOGY
what drug characteristics are compatible with breastfeeding?

A
  • high molecular weight
  • high protein binding
  • low lipid solubility
  • lower pH
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6
Q

VACCINES
which vaccines are not compatible with breastfeeding?

A

yellow fever

all other vaccines are deemed compatible with breastfeeding

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7
Q

LACTATION SUPPRESSION
what medication can be given to stop milk supply?

A

cabergoline 1mg single dose on 1st day postpartum

a small number of women may require 2 doses

SHOULD NOT BE GIVEN IN HTN/PRE-ECLAMPSIA

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8
Q

LACTATION SUPPRESSION
what medication can be given to suppress lactation that is already established?

A

cabergoline 250mg every 12hrs for 2 days

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9
Q

LACTATION ENHANCEMENT
what drug can be prescribed to increase milk supply?

A

metoclopramide

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10
Q

ANTIBIOTICS
which antibiotics can be used in breastfeeding to treat UTIs?

A
  • trimethoprim
  • amoxicillin
  • cefalexin
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11
Q

ANTIBIOTICS
which antibiotic is contraindicated in breastfeeding?

A

nitrofurantoin (if infant <3 months old)

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12
Q

ANALGESIA
are NSAIDs safe during breastfeeding?

A

yes they are safe

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13
Q

ANALGESIA
are opioids safe in breastfeeding?

A

no - should be avoided if possible
if opioid is required, infant should be closely observed for sedation, poor-feeding and respiratory depression

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14
Q

ANALGESIA
is codeine safe in breastfeeding?

A

no it is contraindicated

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15
Q

ANALGESIA
is paracetamol safe in breastfeeding?

A

yes - it is safe

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16
Q

ANALGESIA
is aspirin safe in breastfeeding?

A

generally avoided due to risk of Reye’s syndrome

at antiplatelet doses it is believed to be safe

17
Q

ANALGESIA
is dihydrocodeine safe in breasfeeding?

A

alternative should be used if possible

if it is used, the infant should be closely observed for sedation, poor feeding and respiratory depression

18
Q

ANALGESIA
is tramadol safe in breastfeeding?

A

yes - it is safe

mother should be alert to increased sleepiness, limpness, poor feeding or breathing difficulties in infant

19
Q

ANTIDEPRESSANTS
is TCAs safe in breastfeeding?

A

yes (all other than doxepin) - if baby is full term and health

infant should be monitored for sedation, poor feeding + behavioural disturbances

avoid other sedating agents as sedation can be additive

20
Q

ANTIDEPRESSANTS
what are the first line options for antidepressants when breastfeeding?

A

SSRIs = sertraline or paroxetine

21
Q

ANTIDEPRESSANTS
is fluoxetine safe in breastfeeding?

A

no - it should not be used

22
Q

ANTIDEPRESSANTS
are MAOIs (e.g. phenelzine) safe in breastfeeding?

A

no - should not be used

23
Q

ANTIDEPRESSANTS
are SSRIs and SNRIs safe in breastfeeding?

A

yes - they are safe

24
Q

CONTRACEPTION
when can POP be used?

A

any time after delivery

25
Q

CONTRACEPTION
when can COCP be used?

A

3 weeks after delivery or after 6 weeks if other VTE risk factors are present

26
Q

CONTRACEPTION
when can IUD and IUS be used?

A

either inserted within 48hrs of birth or after 4 weeks

27
Q

CONTRACEPTION
when can depo injection be used?

A

any time after delivery

28
Q

CONTRACEPTION
when can the implant be used?

A

any time after delivery

29
Q

ANTIHISTAMINES
what antihistamines are sedating?

A

chlorphenamine
promethazine

30
Q

ANTIHISTAMINES
which antihistamines are non-sedating?

A

cetirizine
loratadine

31
Q

ANTIHISTAMINES
which antihistamines are preferred in breastfeeding?

A

non-sedating (cetirizine or loratadine)

sedating antihistamines can cause drowsiness and irritability - if they are used the infant should be monitored for drowsiness

32
Q

TOPICAL ALLERGY TREATMENT
are topical agents e.g. eye drops pr nasal decongestants safe in breastfeeding?

A

yes - they are considered safe

33
Q

what types of medications should you avoid prescribing?

A
  • modified release drugs (shorter half life = better
  • avoid new medications as there is little data available

MY REVISION - PSA (5 decks)

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