Drug use in lactating mothers.

In the women breast, the milk-producing glands are surrounded by fine blood vessels. Fine molecules for example drugs can enter into breast milk from the blood. Drugs that are soluble in fat may enter into breast milk more easily. This is how drugs can be passed to a breastfed baby through the mother’s breast milk.

When a breast-feeding mother takes a drug, it can either causes

• insignificant effects on the baby (because the amount of drug passed through the milk is too small) or
• adverse/unwanted effects on the infant or
• a reduction in the production of  breast milk

Lactating mothers should consult their doctors or pharmacists for further details.

What are the factors that a doctor considers before prescribing or administering a drug to a breast-feeding mother?

They include whether:

• the drug therapy is really needed.
• the drug is the least toxic drug and yet is effective.
• the dosing schedule can be timed/arranged to reduce the drug delivered to the baby.
• the drug can also be used for the baby.
• the baby suffered from any medical problem such as liver or renal failure that would affect the drug metabolism or excretion and cause drug accumulation in the baby.
• the drug amount delivered through the breast milk reaches a therapeutic dose in the baby.
• the idiosyncratic or adverse reactions affect the baby.
• the drug produce any side effects.

Note:

• Lactating mothers must avoid using drugs unnecessarily. Usually the doctor will assess the potential risk against the benefit of using the drug for both mother and infant.
• Breast-feeding mothers must avoid using drugs that are known to cause serious side effects in adults. Lactation should be discontinued if the treatment is necessary and there is no suitable alternative therapy available.
• Lactating mothers should breast-feed their baby first before administering the medication.
• Lactating mothers must avoid breast-feeding when drug levels in the breast milk are highest. Consult your doctor or pharmacist.
• Breast-feeding mothers should use the most appropriate route of administration.
• Before taking any over-the-counter drugs including herbal preparation, lactating mothers must consult their doctors first.
• Avoid excessive intake of alcohol and caffeine drinks.