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New Guidance on Medications in Mother’s Milk

Finally, the American Academy of Pediatrics (AAP) has updated its statement “The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics.” The news is both favorable and reassuring: “Only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants.”

In what may be a nod to the 12-year period since the last statement on this topic was issued, the authors decide to identify authoritative sources for the latest research about medications, rather than to tackle the impossible goal of summarizing all we know about possible medications. “More current and comprehensive information is now available on the Internet, as well as an application for mobile devices, at LactMed … Therefore, with the exception of radioactive compounds requiring temporary cessation of breastfeeding, the reader will be referred to LactMed to obtain the most current data on an individual medication.”

Note that use of several narcotic pain medications (codeine, hydrocodone, and oxycodone) is discouraged. (Remember the FDA’s codeine warning in 2007?)

In addition, the long-term effect of psychoactive drugs on the nursing infant should be handled cautiously, with risk-benefit counseling, and possible monitoring of infant growth and neurodevelopment. Concern is also noted about several drugs for substance abuse.

Health care professionals who care for breastfeeding women are encouraged to read the full text of this article.
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