Many breastfeeding women are wrongly advised to stop taking necessary medications or to discontinue nursing because of potential harmful effects on their infants. In a new clinical report, “The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics,” published in the September 2013 Pediatrics (published online Aug. 26), the American Academy of Pediatrics (AAP) provides guidance to physicians regarding drug exposure and reaffirms the recommendation that most medications and immunizations are safe during lactation. It is important for breastfeeding mothers to inform their child’s pediatrician about all of the medications they are taking, including herbal products. Not all drugs are present in clinically significant amounts in human milk or pose a risk to the infant. Certain classes of drugs can be problematic, either because of accumulation in breast milk or due to their effects on the nursing infant or mother. The most common products of concern include pain medications, antidepressants, and drugs to treat substance/alcohol abuse or smoking cessation. Breastfeeding does not interfere with the infant’s immune response to most routine immunizations and may even protect against the incidence of fever after being immunized. Vaccines recommended for the mother during the postpartum period are designed to protect the infant and the lactating mother. Even though most drugs and therapeutics are safe for breastfeeding mothers and infants, the AAP advises all physicians to obtain the most up-to-date information on drugs and lactation. The National Institutes of Health (NIH) provides an online database available at LactMed (http://toxnet.nlm.nih.gov) which can aid physicians in obtaining current information on specific drugs to help guide their advice to breastfeeding women.
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.