Meds in Breast Milk Flashcards
According to NHANES data, at 6 months of age ___% infants are still being breastfed?
~35%
of 77% discharged br. fdg
Name the 6 most common types of medications used by lactating mothers:
- Multivitamins
- NSAIDS
- Acetaminophen
- Progestins
- Antibiotics
- Decongestants
True/False: Lactating mothers take significantly more meds than pregnant mothers.
True
The pH of Human milk is about ____
vs. cow’s milk pH of ____
- 0
6. 85
Human milk is a suspension of:
fat and protein in lactose and mineral solution
How many mL’s of milk can lactating mothers easily produce in a day?
600 mL’s
The rate of milk synthesis is greatest when the breast is ______ and minimal when it is ______
empty
full
the biologic components in breastmilk are designed to do what?
Protect the infant
Accelerate maturation of physiologic processses
Provide ideal nutrient supply to the infant for 1st 6 months
After how many months do infants’ caloric needs require supplemental food to breastmilk?
6 months
What is the mechanism of drug excretion in human milk?
Diffusion
(depends on degree of ionization of drug)
-assumption of pH difference across membrane
Who is at most risk of adverse events of meds in human milk?
The very young infant/neonates
Most drugs w/molecular wt
200 Daltons
True/False: Concentrations in milk parallel plasma concentrations in time
True
True/False: Studies imply there is slow transport of meds from plasma to milk
False, they imply rapid transport
In general, the total amount of drug available for the infant to absorb is ___% of the maternal dose.
1%
How can absorption by the baby be minimized?
By breastfeeding at times when maternal levels are at it’s lowest
True/False: the general med risk to infant is very small w/exception of the neonate and <2 months
True
Use of Radioactive Isotopes in lactating mothers is rare/common.
What might they need to do?
Common
May need to delay test, change test, d/c bf for set period of time. Rarely discontinue BF
True/False: Until more data is available, herbal products should be avoided by nursing mothers.
True
Are herbal products regulated by the FDA?
Are their contents defined?
Is purity standard?
No
No
No
What supplement is frequently suggested by both Lactation specialists and physicians to increase milk supply?
Fenugreek
Are silicone breast implants a contraindication to breastfeeding?
No
What can happen to milk supply when a lactating mother takes oral contraceptives?
Milk supply/production decreases
~best to wait until supply is established
True/False: virtually all psychotropic meds (antidepressants, antianxiety, and antipsychotic meds) have been found in breastmilk.
True
What is the milk/plasma ration of psychotropic drugs?
< 1
Are there short-term effects w/psychotropic drugs and breastmilk?
Long-term effects?
No
Unknown
