Breast-feeding is the best method of feeding neonates and younginfants.1 Its popularity has increased in recent years,2 althoughin 1995 only about 60 percent of new mothers in the United Stateswere breast-feeding their infants at the time of hospital discharge.3Current recommendations suggest that in the absence of contraindications,women should breast-feed their infants for at least the first12 months of life. However, many mothers are likely to needto take medications at some point during this time.4,5 The possibleeffects of these medications on breast-fed infants are thereforeof great concern.
Assessing the Risk of Drug-Induced Toxicity among Breast-Fed Infants
Excretion of Drugs in Breast Milk
Determinants of Levels of Exposure
Risk of Adverse Outcomes
Drugs That Require a Careful Assessment of Risk
Antidepressant Drugs and Lithium
Fluoxetine
Doxepin
Sertraline
Lithium
Antiepileptic Drugs
Cardiovascular and Antihypertensive Drugs
Immunosuppressant Drugs
Drugs of Abuse
Cocaine and Marijuana
Methadone
Nonmedicinal Substances
Caffeine
Ethanol
Nicotine
Iodine-Containing Contrast Medium and Antiseptic Agents
Drugs of Choice for Breast-Feeding Women
Conclusions
Source Information
From the Division of Clinical Pharmacology and Toxicology, Research Institute, the Hospital for Sick Children, and the Departments of Paediatrics and Pharmacology, University of Toronto both in Toronto.
Address reprint requests to Dr. Ito at the Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8, Canada, or at ito@sickkids.on.ca.
References
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Akus, M., Bartick, M.
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Zimetbaum, P.
(2007). Amiodarone for Atrial Fibrillation. NEJM
356: 935-941
[Full Text]
Kwok, B., Yamauchi, A., Rajesan, R., Chan, L., Dhillon, U., Gao, W., Xu, H., Wang, B., Takahashi, S., Semple, J., Tamai, I., Nezu, J.-I., Tsuji, A., Harper, P., Ito, S.
(2006). Carnitine/xenobiotics transporters in the human mammary gland epithelia, MCF12A. Am. J. Physiol. Regul. Integr. Comp. Physiol.
290: R793-R802
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Gardiner, S. J., Begg, E. J.
(2006). Breastfeeding During Tacrolimus Therapy. Obstet Gynecol
107: 453-455
[Abstract][Full Text]
Feig, D. S., Briggs, G. G., Kraemer, J. M., Ambrose, P. J., Moskovitz, D. N., Nageotte, M., Donat, D. J., Padilla, G., Wan, S., Klein, J., Koren, G.
(2005). Transfer of Glyburide and Glipizide Into Breast Milk. Diabetes Care
28: 1851-1855
[Abstract][Full Text]
Briggs, G. G., Ambrose, P. J., Nageotte, M. P., Padilla, G., Wan, S.
(2005). Excretion of Metformin Into Breast Milk and the Effect on Nursing Infants. Obstet Gynecol
105: 1437-1441
[Abstract][Full Text]
Weissman, A. M., Levy, B. T., Hartz, A. J., Bentler, S., Donohue, M., Ellingrod, V. L., Wisner, K. L.
(2004). Pooled Analysis of Antidepressant Levels in Lactating Mothers, Breast Milk, and Nursing Infants. Am. J. Psychiatry
161: 1066-1078
[Abstract][Full Text]
Anderson, P. O., Pochop, S. L., Manoguerra, A. S.
(2003). Adverse Drug Reactions in Breastfed Infants: Less Than Imagined. CLIN PEDIATR
42: 325-340
[Abstract]
Chaudron, L. H.
(2003). Postpartum Depression: What Pediatricians Need to Know. Pediatr. Rev.
24: 154-161
[Full Text]
Coady, N. T.
(2002). Maternal Transplantation Medications During Breastfeeding. J Hum Lact
18: 66-68
[Abstract]
Lawrence, R. A.
(2001). A 35-Year-Old Woman Experiencing Difficulty With Breastfeeding. JAMA
285: 73-80
[Full Text]