Principles of pharmacotherapy during breastfeeding

The article aims at recommendations how to assess the risk of drugs, taken by the mother, to her breastfed child. Some amount of drug present in breast milk always carries possible risks for an infant, however, these risks should be weight to benefits of breastfeeding itself. Breastfeeding offers big advantages for health state, healthy growth and development of the child, but also for the health of the mother. Therefore, it should not be prematurely terminated due to mother´s therapy without any concrete serious reason. During the assessment of possible risks for the infant it is necessary to study all available data on the transfer of the drug into breast milk, on pharmacokinetics in the infant and on the documented or suspected adverse reactions in breastfed infants. The general health state of the infant should be taken into consideration as well. The basic source of information is the Summary of Product Information for the concrete medicinal product which contains well documented and approved data. However, for majority of medicinal products there is not enough of well-documented data on drug use during breastfeeding. Therefore, any further data should be searched in scientific literature. A physician who prescribes a medicine to a breastfeeding woman should always explain her all the possible risks and instruct her on the possible manifestation of adverse reactions and on the need to consult in time a paediatrician. During the treatment of the mother the physician should be with her in close contact and should carefully follow conditions of the breastfed child.

Keywords: breastfeeding, breast milk, breastfed child, drugs, adverse drug reactions.