lactation Flashcards
general recommendation for breastfeeding
take the meds immediately after feeding the baby, or when the baby will be sleeping for long periods
ethanol
avoid feeding within 2 hours
caffeine
high milk transfer within 1 hour
pain
use APAP and NSAIDs first
FDA warns against oxycodone, codeine, and tramadol
buprenorphine and methadone are not contraindicated for addiction
cough/cold
avoid decongestants, antihistamines 1st generation, anticholinergics, DM, codeine
hearburn
PPI or H2RA are ok except cimetidine
cardio
avoid atenolol and acebutelol
ACE, ARB, diuretics OK
estrogen
avoid
thrombosis
warfarin low passage
UFH/LMWH useful
anxiety
SSRIs not contraindicated
benzos may pass but not contraindicated
mastitis
keflex, clindamycin, azithromycin
nipple candida
topical/oral, need to treat baby
HIV
infant antiretrovirals
Flu
oseltamivir
if 2 gm flagyl is used for trichomonas
avoid feeding x 12 hours
positive benefits of breast feeding to infant
improved development, decreased mortality
protection against disease
decreased risk of DM, leukemia, obesity, asthma, ADHD
provides intestinal microbiome
breastfeeding is especially important in ___
premature infants, newborns
positive benefits of breastfeeding to mother
decreases postpartum bleeding, decreased risk of breast and ovarian cancer, hip fracture post menopause, DM
increased bonding
drugs that can reduce milk supply
alcohol
anticholinergic antihistamines
diuretics
estrogens
nicotine
pseudoephedrine
drugs that can enhance milk supply
metoclopramide
fenugreek
PK factors that affect drug passage into milk
drug half life, bioavailability, negligible amounts of drug removed in milk
drugs contraindicated in lactation
amiodarone
antineoplastics, immunosuppressants
bromocriptine
recreational drugs
ergotamine
lithium
misoprostol
single dose flagyl: temporary dc
isotretinoin
