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 |
|
|
If a drug must be taken by a mother, and she wishes to continue to breastfeed, it may be possible to schedule the doses so that peak plasma and milk levels of the drug do not coincide with breastfeeding sessions. In most cases, it’s best for the mother to breastfeed just before taking a dose of a drug and / or at least two hours after taking a dose. Short-acting drugs taken on an every three to six hour schedule usually reach peak plasma and milk levels in approximately one hour.
|
| 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 |
| |
|
