Meds in Breast Milk

Question 1

According to NHANES data, at 6 months of age ___% infants are still being breastfed?

Answer 1

~35%

of 77% discharged br. fdg

Question 2

Name the 6 most common types of medications used by lactating mothers:

Answer 2

1. Multivitamins
2. NSAIDS
3. Acetaminophen
4. Progestins
5. Antibiotics
6. Decongestants

Question 3

True/False: Lactating mothers take significantly more meds than pregnant mothers.

Answer 3

True

Question 4

The pH of Human milk is about ____

vs. cow’s milk pH of ____

Answer 4

7. 0

6. 85

Question 5

Human milk is a suspension of:

Answer 5

fat and protein in lactose and mineral solution

Question 6

How many mL’s of milk can lactating mothers easily produce in a day?

Answer 6

600 mL’s

Question 7

The rate of milk synthesis is greatest when the breast is ______ and minimal when it is ______

Answer 7

empty

full

Question 8

the biologic components in breastmilk are designed to do what?

Answer 8

Protect the infant
Accelerate maturation of physiologic processses
Provide ideal nutrient supply to the infant for 1st 6 months

Question 9

After how many months do infants’ caloric needs require supplemental food to breastmilk?

Answer 9

6 months

Question 10

What is the mechanism of drug excretion in human milk?

Answer 10

Diffusion
(depends on degree of ionization of drug)
-assumption of pH difference across membrane

Question 11

Who is at most risk of adverse events of meds in human milk?

Answer 11

The very young infant/neonates

Question 12

Most drugs w/molecular wt

Answer 12

200 Daltons

Question 13

True/False: Concentrations in milk parallel plasma concentrations in time

Answer 13

True

Question 14

True/False: Studies imply there is slow transport of meds from plasma to milk

Answer 14

False, they imply rapid transport

Question 15

In general, the total amount of drug available for the infant to absorb is ___% of the maternal dose.

Answer 15

1%

Question 16

How can absorption by the baby be minimized?

Answer 16

By breastfeeding at times when maternal levels are at it’s lowest

Question 17

True/False: the general med risk to infant is very small w/exception of the neonate and <2 months

Answer 17

True

Question 18

Use of Radioactive Isotopes in lactating mothers is rare/common.
What might they need to do?

Answer 18

Common

May need to delay test, change test, d/c bf for set period of time. Rarely discontinue BF

Question 19

True/False: Until more data is available, herbal products should be avoided by nursing mothers.

Answer 19

True

Question 20

Are herbal products regulated by the FDA?
Are their contents defined?
Is purity standard?

Answer 20

No
No
No

Question 21

What supplement is frequently suggested by both Lactation specialists and physicians to increase milk supply?

Answer 21

Fenugreek

Question 22

Are silicone breast implants a contraindication to breastfeeding?

Answer 22

No

Question 23

What can happen to milk supply when a lactating mother takes oral contraceptives?

Answer 23

Milk supply/production decreases

~best to wait until supply is established

Question 24

True/False: virtually all psychotropic meds (antidepressants, antianxiety, and antipsychotic meds) have been found in breastmilk.

Answer 24

True

Question 25

What is the milk/plasma ration of psychotropic drugs?

Answer 25

< 1

Question 26

Are there short-term effects w/psychotropic drugs and breastmilk?

Long-term effects?

Answer 26

No

Unknown