Wednesday, July 14, 2010

Reducing risk of Infant Exposure to Drugs in Breast Milk


A drug should be used only if medically necessary and treatment cannot be delayed until the infant is ready to be weaned.

Drug selection
• Consider whether the drug can be safely given directly to the infant
• Select the drug that passes poorly into breast milk with the lowest milk-to-plasma ratio
• Avoid long-acting formulations e.g. sustained release
• Determine length of therapy and if possible avoid long-term usage

Feeding pattern
• Avoid nursing during times of peak drug concentration
• If possible, plan breast-feeding before administration of the next dose

Other considerations

• Always observe the infant for unusual signs or symptoms e.g. sedation, irritability, rash, decreased appetite, failure to thrive
• Discontinue breastfeeding during the course of therapy if the risks to the fetus outweigh the benefit of nursing
• Provide adequate patient education to increase the understanding of risk factors.


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