Pharmacology of breastfeeding Flashcards
benefits of breastfeeding a baby
Reduced risk of infections – GI infections, UTIs, otitis media, respiratory diseases, NEC (in preterm babies)
Neurological development – studies show link between BF and increases scores in cognitive function
Protection against later development of atopic diseases, eg. Eczema
Lower incidence of insulin-dependent diabetes
Lower incidence of Sudden Infant Death Syndrome (SIDS) – linked to neurological maturation
benefits of breast feeding for the mother
Reduction in risk of pre-menopausal breast cancer, ovarian cancer and hip fractures
Less uterus bleeding, quicker return to it’s normal size
Prevents post-natal depression
Exclusively breastfeeding can provide contraception (LAM) – lactational amenorrhoea method*
Faster weight loss from pregnancy weight gain
Saves money compared to formula
what drugs should be avoided while breastfeeding
Cytotoxics
Immunosuppressants
Anti-convulsants (not all)
Drugs of abuse (consider recreational)
Amiodarone
Lithium
Radio-iodine
tetracycline
risk permanent tooth staining infant
isoniazid
risk pyridoxine deficiency in infant
barbotiates
letheragy sedation and poor suck reflexes
chloral hydrate
drowsiness if infant fed at peak
diazepam
drug accumulation and sedation
methadone
risk withdrawal if breast feeding stops
iodine
thyroid suppression and risk of cancer
propylthiouracil
suppression thyroid function in infant
Cabergoline
inhibition of lactation
Metoclopramide
enhancement of lactation
Dose – 10mg 2-3 times daily.
All study based information, no published dosing. Prolactinoma (enhancement of milk production).
Also Domperidone is an option.
Herbal Medicines / OTC Medicines
Important to consider herbal and OTC medicines. Remember ‘no information’ does not mean ‘safe’.
Very limited scientific data for herbal medicines, should ideally be avoided during lactation. Some herbal medicines can have hormonal effects.
Important to ask about all medication taken by mother, not just prescribed medicines.
Principles of Prescribing in Breastfeeding
Avoid unnecessary drug use – always consider non-pharmaceutical options
Always check up to date information resources
If medicine is licensed and safe for use in paediatrics/neonates; then it is likely to be safe to be used during breastfeeding (amount in milk will be less than treatment doses used in baby)
Try to choose drugs with pharmacokinetic properties which reduce infant exposure to drug eg, highly protein bound drugs
Always weigh up the benefit of breastfeeding to mother and infant – should never discourage feeding unless in extreme circumstances
