CHRONIC ILLNESS AND THE BREASTFEEDING MOTHER
Main Article Content
Keywords
Breastfeeding, breast milk, chronic disease, antidepressants, antiepileptics, anxiolytics, antipsychotics, information sources
Abstract
Medications taken for chronic illness (e.g., depression, epilepsy, immunological conditions ) while breastfeeding pose challenges to risk -assessment. Based on several cases of drug toxicity (or lack thereof) in the breastfeeding infant, individual risk : benefit analyses are discussed. The benefits of human milk are highlighted, together with clinically important principles for patient management, the spectrum of adverse effects in the infant, and emerging concerns regarding the safety of some medications during breastfeeding. A practical guide for patient management is presented.
References
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13. Ito S, Koren G, Einarson TR. Maternal noncompliance with antibiotics during breastfeeding. Ann Pharmacother 1993;27(1):40- 42.
14. Ito S, Moretti M, Lian M, et al. Initiation and duration of breast-feeding in women receiving antiepileptics. Am J Obstet Gynecol 1995;172(3):881- 886. 15. Lee A, Moretti ME, Collantes A, et al.of breastfeeding and physicians’ advice: A cohort study of women receiving propylthiouracil. Pediatrics 2000;106(1):27- 30.
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2. Tanaka PA, Yeung DL, Anderson GH. Infant feeding practices: 1984 -85 versus 1977- 78. CMAJ 1987[cited 2014 Jun 29];136(9):940- 944. Available from: http://www.n cbi.nlm.nih.gov/pmc/articles/pmid/ 3567809
3. Centers for Disease Control. Breastfeeding Report Card – United States, 2009 [cited 2014 Jun 29]. Available from: http://www.cdc. gov/breastfeeding/data/reportcard/reportcard2009.htm
4. Centers for Disease Control. Breastfeeding Report Card – United States, 2013 [cited 2014 Jun 29]. Available from: http://www.cdc.gov/breastfeeding/pdf/2013breas tfeedingreportcard.pdf
5. Statistics Canada. Health at a Glance. Breastfeeding trends in Canada [Internet]. Ottawa: Statistics Canada; 2013 -11- 15 [cited 2014 Jun 29]. Available from: http://www.statcan.gc.ca/pub/82 -624- x/2013001/article/11879- eng.htm
6. Koshimichi H, Ito K, Hisaka A, et al. Analysis and prediction of drug transfer into human milk taking into consideration secretion and reuptake clearances across the mammary epithelia. Drug Metab Dispos 2011[cited 2014 Jun 29];39(12)”2370- 2380. Available from: http://dmd.aspetjournals.org/content/39/12/2370. full .pdf+html
7. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS -acting drugs. Can J Clin Pharmacol 2004;11(2):e257- e266.
8. Weissman Am, Levy BT, Hartz AJ, et al. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry 2004[cited 2014 Jun 29];161(9):1066- 1078. Available from: http://ajp.psychiatryonline.org/article.aspx?articl eID=176862
9. Berle JØ, Spigset O. Antidepressant use during breastfeeding. Curr Women's Health Rev. 2011[cited 2014 Jun 29];7(1):28- 34. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC 3267169
10. Weinstein MR, Goldfield M. Lithium carbonate treatment during pregnancy; report of a case. Dis Nerv Syst 1969;30(12):828- 832.
11. Moretti ME, Koren G, Verjee Z, Ito S. Monitoring lithium in breast milk: an individualized approach for breastfeeding mothers. Ther Drug Monit 2003; 25(3):364- 366.
12. Lee A, Giesbrecht E, Dunn E, Ito S. Excretion of quetiapine in breast milk. Am J Psychiatry [letter]. 2004 [cited 2014 Jul 5];161(9):1715- 1716. Available from: http://aj p.psychiatryonline.org/data/Journals/AJP /3764/1715- a.pdf
13. Ito S, Koren G, Einarson TR. Maternal noncompliance with antibiotics during breastfeeding. Ann Pharmacother 1993;27(1):40- 42.
14. Ito S, Moretti M, Lian M, et al. Initiation and duration of breast-feeding in women receiving antiepileptics. Am J Obstet Gynecol 1995;172(3):881- 886. 15. Lee A, Moretti ME, Collantes A, et al.of breastfeeding and physicians’ advice: A cohort study of women receiving propylthiouracil. Pediatrics 2000;106(1):27- 30.
16. LactMed [Inter net]. Bethesda (MD): National Library of Medicine (US), TOXNET Toxicology Data Network; 2013 Aug 5 [cited 2014 Jul 8]. Available from: http://www.nlm.nih.gov/news/lactmed_announc e_06.html
17. Ito S, Colantonio D. “Drugs in Lactation” Analysis Consortium Phase 1. DLAC Phase 1. Catalyst Grant: Post Market Drug Safety and Effectiveness [Internet]. Ottawa (ON): Canadian Institutes of Health Research, Project Information; 2012 Feb 27 [cited 2014 Jul 8]. Available from: http://webapps.cihr - irsc.gc.ca/cfdd/db_search?p_language=E
18. Colantonio D. Laboratory Medicine and Pathology [Internet]. Toronto (ON): University of Toronto [ cited 2014 Jul 8]. Available from: http://www.lmp.utoronto.ca/research/faculty - research -database/colantonio -david