Klin Farmakol Farm. 2019;33(4):24-29 | DOI: 10.36290/far.2019.028

Principles of pharmacotherapy during breastfeeding

Eva Jirsová
Státní ústav pro kontrolu léčiv, Praha

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.

Published: January 1, 2020  Show citation

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Jirsová E. Principles of pharmacotherapy during breastfeeding. Klin Farmakol Farm. 2019;33(4):24-29. doi: 10.36290/far.2019.028.
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References

  1. American Academy of Pediatrics: Breastfeeding and the Use of Human Milk. Pediatrics [online]. 2012; 129(3): e827-e841, dostupné na: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2011-3552 Go to original source... Go to PubMed...
  2. Wambach K, Riordan J. Breastfeeding and human lactation, Burlington, MA: Jones&Bartlett Learning, 2016.
  3. WHO: Breastfeeding and Maternal Medication, Recommendations for Drugs in the 11th WHO Model List of Essential Drugs. WHO 2002.
  4. Hale T.W. Medications and Mother's Milk., 2019, 18th edition, Spronger Publishing Co Inc.
  5. WHO Guideline Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services 2017, dostupné na https://apps.who.int/iris/bitstream/handle/10665/259386/9789241550086-eng.pdf;jsessionid=4659A70EAB2D0FABC47A09BF325F2FF4?sequence=1
  6. Complementary Feeding. A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nurt. 2017; 64(1): 119-132. Go to original source... Go to PubMed...
  7. Meador KJ, Baker GA, Browning N, et al. Breastfeeding in children of women taking antiepileptic drugs: Cognitive outcomes at age 6 years. JAMA Pediatr. 2014; 168: 729-736. Go to original source... Go to PubMed...
  8. Vajda F. Epilepsy. Effects of exposure to antiepileptic drugs during development. Nat Rev Neurol. 2014; 10: 11-12. Go to original source... Go to PubMed...
  9. Briggs G.G, Freeman R.K, Yaffe S.J. Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. 11h ed. Lippincott Williams&Wilkins 2017.
  10. Matalová P, Urbánek K, Anzenbacher P: Specific features of pharmacokinetics in children, Drug Metab Rev. 2016; 48(1): 70-79. Go to original source... Go to PubMed...
  11. Databáze léčiv, dostupná na http://www.sukl.cz/modules/medication/search.php
  12. LactMed (součást databáze Toxnet) dostupná na http://toxnet.nlm.nih.gov/cgi‑bin/sis/htmlgen?LACT
  13. Schaefer Ch, Peters P. W. J, Miller R. K. Drugs during Pregnancy and Lactation, Elsevier Books, 2014, 3rd edition.




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