Resources and drug information on pharmacotherapy in breastfeeding

Breastfeeding is the optimal method of infant nutrition in early life, supporting physical health, reinforcing maternal-infant bonding, and offering economic and ecological benefits. The aim of this article is a narrative review of available professional information sources utilized by pharmacists, paediatricians, and other healthcare providers in breastfeeding pharmacotherapy decision-making. These include primary evidence (e.g., case reports, clinical lactation studies, adverse drug events reporting systems), secondary systematic reviews and meta-analyses, and tertiary sources comprising authoritative monographs (e.g., Hale's Medications & Mothers' Milk), clinical guidelines, or fact-based databases (e.g., LactMed, e-lactancia). Other information is received from regulatory documents (summary of product characteristics), websites for health care professionals, and drug information services (e.g., InfantRisk Center, Specialist Pharmacy Service). Access to such information sources enable individualized assessment of infant exposure while providing detailed data on drug transfer into breast milk, milk-to-plasma concentration ratios, and other pharmacokinetic properties, health condition of infant and mother as well as mother´s willingness to breastfeed. Critical appraisal of these sources with focus on current and evidence-based information are together with a multidisciplinary approach essential to ensure safe and effective treatment for breastfeeding women.