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Drugs in Lactation
Margarita A P Berwick1, Anika J Heuberger2, Joimishael V Martin2
1Orlando Health Winnie Palmer Hospital for Women and Babies Ob/Gyn Hospitalist Group, Orlando, FL, USA.
None:
Medication management in lactation is a challenging topic for healthcare practitioners around the world. In contrast to traditional advice, very few medications are now thought to be absolutely contraindicated in breastfeeding. As data from case reports, quantitative studies of medication transfer to milk, and lactation physiology accumulate, fact-based guidance for use of medications can be increasingly provided. This review presents the strengths and weaknesses of current scientific knowledge underlying recommendations for use of medications during breastfeeding, describes key pharmacokinetic factors influencing infant drug exposure in breastmilk, and provides a practical algorithm and case study on use of clinical resources as well as pharmacologic data to help in development of a management plan for lactating individuals with various medication needs.
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