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Drug excretion into breast milk--overview
1Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, Department of Pediatrics, 555 University Avenue, ON M5G 1X8, Toronto, Canada. shinya.ito@sickkids.ca
Advanced Drug Delivery Reviews
|April 23, 2003
Summary
Breastfeeding is best for infants, but medication use can cause concern. A careful, case-by-case risk assessment is crucial for medication safety during breastfeeding.
Area of Science:
- Perinatal Medicine
- Pharmacology
- Infant Nutrition
Background:
- Breastfeeding is the recommended infant feeding method for early months.
- Maternal medication use can lead to formula feeding or untreated conditions due to infant safety concerns.
- Limited data exists on medication transfer during breastfeeding, complicating risk assessment.
Purpose of the Study:
- To review the benefits of breastfeeding.
- To examine the impact of maternal medication on infant health and maternal decisions.
- To discuss factors influencing infant exposure to medications via breast milk.
Main Methods:
- Literature review on breastfeeding, maternal medication use, and infant exposure.
- Analysis of drug excretion mechanisms into breast milk.
- Discussion of ethical challenges in studying medication transfer.
Main Results:
- Most medications are compatible with breastfeeding, but significant infant toxicity cases necessitate individual risk assessment.
- Physicochemical properties and carrier-mediated processes influence drug transfer into milk.
- Lack of comprehensive data hinders accurate risk evaluation.
Conclusions:
- Individualized risk-benefit analysis is essential for managing medications during breastfeeding.
- Further research is needed to improve understanding of drug transfer and infant safety.
- Informed decisions support both maternal health and optimal infant nutrition.