The Italian Society of Perinatal Medicine's Working Group on Breastfeeding has released a statement on the use of medication while breastfeeding, which was published in the February 2016 Issue of the Journal of Human Lactation. This group found that consistency was lacking in research-based information given to breastfeeding mothers from a wide variety of healthcare providers regarding the use of various medications.
The statement contains nine points, which are summarized here:
1. Professional advice should not be exclusively based on a precautionary principle, discouraging breastfeeding even when the lactation risk for the nursing infant is very low.
2. When asked for advice on the use of a drug during breastfeeding, clinicians may need to take some time to fully evaluate scientific evidence.
3. The risks of medication exposure should be weighed against the risks associated with breastfeeding interruption and formula feeding.
4. The amount of drug transferred into breast milk and its possible effects on the breastfed infant depend both on the pharmacokinetic characteristics of the drug and on the mother's and infant's capability to metabolize each drug.
5. To limit drug transfer from the mother to the nursing infant, the drug may be taken soon after a breastfeed.
6. If a medication contraindicated during lactation has to be taken for a limited time, the nursing mother can express milk and discard it during the treatment, and restart breastfeeding when she stops taking the drug.
7. The fear of possible negative effects on cognitive outcome of long-term exposure to medications should not represent a reason to discourage breastfeeding.
8. Multi drug therapy may increase the risk of side effects due to drug interactions.
9. In clinical practice, when giving advice on the use of medications during breastfeeding, health professionals should find and use the most authoritative sources of information.
What are some good sources for research-based information on medications while breastfeeding? Here are just a few:
1. Lactmed. This is a part of the (US) National Library of Medicine's Toxicology Data Network.
2. Medications and Mothers' Milk, 2014, by Thomas Hale, Ph.D., RPh.
3. Tetarology Information Service, available throughout Europe.
4. Infant Risk Center, open to talk to healthcare professionals Monday-Friday, 8:00-5:00 CST. 806-352-2519.
5. Breastfeeding and Human Lactation Study Center. 585-275-0088.
6. Briggs, Freeman & Jaffe's Drugs in Pregnancy and Lactation, 2014.
I hope this is helpful in supporting the continuation of breastfeeding for the mothers and infants with whom you work.
Davanzo, R., Bua, J., DeCunto, A., Farina, M. L., DePonti, F., Clavenna, A., Mandrella, S., Sagone, A., and Clementi, M. (2016). Advising mothers on the use of medications during breastfeeding: A need for a positive attitude. Journal of Human Lactation; 32(1),15.
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