When counseling breastfeeding mothers who intend to take or are taking medications (prescription, over-the-counter, and/or herbal), the questions below should be considered and asked. The provided answers are necessary to properly counsel mothers on the safe and effective use of medications while breastfeeding. A stepwise approach based upon these answers can then be used to minimize infant drug exposure while breastfeeding. The steps evolve from not taking a medication to discontinuing breastfeeding. Steps can be skipped or combined as appropriate. Following this approach almost always allows the nursing infant to continue to breastfeed safely. 1 What is the name, strength, and dosage form of the drug?  SHOW 2 Do you still have the prescription? Or, have you already filled it and are taking the drug?  SHOW 3 Why is the drug being prescribed?  SHOW 4 Do you feel you need to take the drug?  SHOW 5 What does your doctor say regarding breastfeeding outcome and taking the drug?  SHOW 6 What is the drug dosage schedule and how often do you nurse?  SHOW 7 How old is the baby?  SHOW 8 Was your baby full-term or premature?  SHOW 9 What is your baby’s weight?  SHOW 10 Is your baby currently receiving any medication?  SHOW 11 Do you know how to hand-express milk or do you have access to a breast pump?  SHOW 12 Is this your first breastfed baby?  SHOW 13 Stepwise Approach to Minimizing Infant Drug Exposure  SHOW 14 Mastitis Antibiotic Algorithm  SHOW   Nursing mothers who develop breast abscesses or mastitis one to four weeks postpartum should be considered as having penicillin-resistant staphylococcal infections.  Drug treatment options in order of preference are:   1. Penicillinase-Resistant Penicillins: dicloxacillin (first choice), cloxacillin, methicillin, nafcillin 2. Macrolides (if allergic to penicillins): azithromycin (first choice), clarithromycin 3. Aminoglycosides: clindamycin, vancomycin (IV) (if incision and drainage necessary) 4. Sulfamethoxazole/trimethoprim (oral): (if incision and drainage necessary) 5. Cephalosporins  6. Linezolid (high rate of thromboplastinemia) 7. Kanamycin 8. Chloramphenicol (do not breastfeed if this drug is necessary)     PLUS analgesic / antipyretic relief as needed