Meds in Human Milk Flashcards
What percent of newborns are dc’d from the hospital breastfeeding?
77%; increased from the 1970s (20%)
What percent of newborns are breastfeeding at 6 mos?
35%; increased from the 1970s (15%)
Why has the incidence of BF increased?
owing largely to the efforts of La Leche & AAP, public health campaigns and federal gov’t support
What are the advantages of BF?
Protection from infx (passive immunity), dec URTI, dec otitis media, dec GI illness, inc bonding/attachment, inc IQ, inexpensive, right temp, right quantitiy, convenient and maternal benefits
What meds are most commonly taken by lactating mothers?
multivits, NSAIDs, Acetaminophen, Progestins, Antibiotics and Decongestants
Who is more likely to medications?
lactating mothers > pregnant women
What is the pH of human milk?
~7.0
What is the pH of bovine milk?
6.8 or <
How much milk can a lactating mother produce per day?
600 mL
What is the composition of human milk?
it is a suspension of fat and protein in a lactose and mineral solution
What are the components of human milk?
immunoglobulins, macrophages, lymphocytes, transferrin, lactoferrin, interferon, complement, fibronectin, erythropoietin and other biological components
How does the composition of human milk vary?
varies with the duration of lactation and even within the time of a single feed
When is the rate of milk synthesis at its maximum?
when the breast is empty
When is the rate of milk synthesis at its minimum?
When the breast is full
When does the infant’s caloric needs require the supplementation of food?
by 6 mos
What are all the components of human milk designed to do?
protect the infant and accelerate the maturation of many physiological processes
Why is the pH of milk important?
high pH can have a significant effect on medications depending on their pH
what is the mechanism of drug excretion via breast milk?
diffusion
what facilitates or impedes drug diffusion?
the degree of ionization of the drug (charge) and the degree of difference of pH across the membrane.
who is at most risk for adverse events r/t drug excretion via BM?
the very young are the most at risk for the potential negative effects of drugs
what drugs/chemicals can easily cross from plasma to BM via simple diffusion?
drugs with a molecular weight <200 daltons
what is the rate of transport from plasma to BM?
rapid
what do concentrations of medications in BM parallel?
plasma concentrations of medications in time
what is the total amount of maternal drug available for infant absorption?
<1%
