Lecture 6 - Lactation Flashcards
how long should you breastfeed?
exclusive first 6 months.
begin within 1hr of birth, continue with complementary foods at least 2 years
breastfeeding benefits baby
dec risk bunch of stuff…..allergies,DM, Cavities, obesity, respiratory illness etc
breastfeeding benefits mom
Delays return of menstrual cycle (LAM)
dec risk of cancers
facilitates weightless
hastens return of uterus to normal size
how to determine if someone meets LAM
Menses return = no
Supplementing breastfeeding with formula = no
Baby older than 6 months = no
Meets LAM, preg risk low
which BC should be used due to inc risk of stroke and clotting during postpartum period?
Progestin only products
what effect does estrogen have on breastfeeding?
Dec milk supply
can reduce lactation duration
avoid in those that breastfeed
Hormones in lactation
prolactin = milk production
oxytocin = milk release
progesterone = suppress milk production (dec during breastfeeding)
Cortisone = delays lactogenesis
Drugs may have impact on infant through breastmilk if…
small Vd
Low MW
Low protein binding
Pass BBB
lipid soluble
high oral bioavail
Drug passing through to breastmilk info
prefer short 1/2 life
weak base transfer easily to milk and trapped in lower pH
Measuring drug in plasma
Milk:Plasma ratio
RID = Relative infant dose
drug found in milk vs drug in blood stream
want to avoid high M:P ratio
RID thats generally safe?
< 10%
some drugs to inc/dec milk production
inc = antipsyh
dec = estrogens + anticholinergics, sudafed
breastfeeding pain Drug of choice?
Tylenol
NSAIDs with shorter half-life if needed
Codeine = risk of toxicity if ultra-rapid metabolizer
Oxy = elim impaired in young infants, metabolite 14X more potent than oxy
Allergy med of choice breastfeeding
2nd gen
Cetirizine pref
loratadine
Desloratadine
Fexofenadine
cough and cold meds during breastfeeding
watch out for alc combo
avoid decongestants due to milk
pseudoephedrine if u must use one
nasal steroids can be used
