Drugs in Breastfeeding

Question 1

How does HCP decide if the risk of the drug passing through breastmilk is acceptable?

Answer 1

BNF
BNF Children – therapeutic range
Plasma Protein binding: Drugs which are highly bound to proteins in the maternal plasma
are unable to transfer into breastmilk at high levels. Ideal drug is highly protein bound >90%
Half-life: Short half-life is preferred
Bioavailability: If a drug can’t be absorbed from the stomach, the baby can’t absorb it from any which passes into breastmilk, therefore, anything ONLY available as an injection
Specialised texts and websites

Question 2

What information does BNF have?

Answer 2

BNF will tell them whether the drug is licenced for use in
breastfeeding mothers
Nothing about the age of baby, how often it is feeding, potential side
effects
The HCP has to take responsibility if something goes wrong
If don’t have access to more information, isn’t it right they are
cautious?

Question 3

Reasons to why drugs will be prescribed?

Answer 3

Inflammatory mastitis - build up of milk production over stimulating , will over build and sit in the breast

Postnatal- difficult deliveries haematoma

Breasts shiny and stretched
Raised temp

Question 4

Fat soluble drugs pass easily in to breast milk

Answer 4

true