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Safe Medications While Breastfeeding Article

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Drug Safety For Breastfeeding Mothers

from: Karlie Bestler

Thanks in part to breastfeeding awareness programs, the number of breastfeeding mothers continues to increase. As the number of breastfeeding mothers increase, so does the use of both legal and recreational by breastfeeding mothers. As a breastfeeding mother, you may need to know about safe medications while breastfeeding. When trying to make a decision about safe medications while breastfeeding, you should be aware that there are three things known for sure about drugs and breastmilk so that breastfeeding mothers can make better decisions about safe medications while breastfeeding:

1. Nearly all drugs pass into human milk.

2. Almost all medications appear in very small amounts, usually less than 1% of the maternal dose in the human milk that the breastfeeding baby will drink.

3. Very few drugs are contraindicated for breastfeeding mothers.

The issue of which drugs are safe to take during lactation is quite complicated. Many factors must be taken into consideration, such as:

1. The method of administration. Your baby is always exposed through the GI tract, but drugs can enter your system several different ways, such as orally, intravenously, intramuscularly, topically, or through inhalation. Topical medications (skin creams) and medications inhaled or applied to the eyes or nose reach the milk in lesser amounts and slower than other routes and are almost always safe for nursing mothers. Oral medications take longer to get into the milk than IV and IM routes since the drug must first go through the mother's GI tract before it enters the bloodstream, and the milk supply. With IV drugs, the medications bypass the barriers in the GI tract to enter the milk quickly and at higher levels. With IM injections, the drugs transfer quickly into the milk because the muscles have so many blood vessels and the drug enters the bloodstream quickly.

2. The amount taken. The higher the dosage, the more of the drug transfers into milk.

3. How often the drug is taken. Medications taken 30 to 60 minutes before you feed are likely to be at peak blood levels when your baby breastfeeds.

4. Your baby's age and maturity level. Premature babies have immature kidney and liver functions and may have trouble processing and eliminating even small quantities of drugs that might not cause problems for larger, full-term infants. Even full-term baby's protective metabolic systems are not fully developed for the first week of life, so they may not be able to handle chemicals in the milk as well as a baby who is several months old.

5. The frequency and volume of feedings. A baby who is breastfeeding once or twice a day and is supplemented the rest of the time will receive less of a drug than the baby who is only breastfeeding and may nurse many times a day.

6. Duration of drug therapy. A drug taken for weeks or months may have a greater impact on breastfeeding than one taken for just a few days.

7. The type of medication. Characteristics of a drug such as the molecular weight, how fat soluble the drug is, and how long it takes for it to be eliminated from your system, or it's half-life, all affect how much of the drug is transferred into milk.

In the last decade the accuracy of the methods used to measure drugs in human milk have improved. This is good because in certain situations, such as breastfeeding a very sick or premature baby, knowing what drugs appear in even very tiny amounts can be significant.

On the other hand, some doctors are hesitant to prescribe any medication for breastfeeding mothers once they know that even a tiny amount enters the mother's milk. Many doctors are afraid to prescribe a medication because of the conservative approach taken toward giving drugs to a pregnant woman. They feel that if a drug might possibly cause birth defects or problems in a pregnant woman, then they shouldn't give it to a lactating woman. The difference is that while the placenta lets drugs enter to cross into the developing fetus's bloodstream, the breast serves as a very effective barrier for a fully developed infant.

In deciding which drug to take, you should always look at the situation from a risk versus benefit perspective. Make informed decisions about safe medications while breastfeeding.

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