Which Medications Are Secure to consider While Breastfeeding

 

How to Breastfeed: Taking Antidepressants

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Safety of anti allergic medications when lactating Dr. Varsha Shridhar

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How can I know what medications are safe to take while pregnant or breastfeeding?

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Mommy’s Minute Safe Medications While Breastfeeding

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What medications and herbal supplements are safe to take while nursing?

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Ask UNMC: Antidepressant medications and breastfeeding

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Medication Safety in Pregnancy and Breast-feeding

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In general, aspirin use is best avoided during breastfeeding. Acetaminophen or ibuprofen may be safer for pain relief. Some expert opinion indicates that low-dose (75 to 325 mg daily) aspirin may be used as a blood thinning agent for use in breastfeeding women who require it. Antidepressants Paroxetine (Paxil) Sertraline (Zoloft) Fluvoxamine (Luvox). ” indicates that most medications and immunizations are safe to use during lactation.

According to the AAP, health care providers should weigh the risks and benefits when prescribing medications to breastfeeding mothers by considering the following: Need for the drug by the mother. Potential effects of the drug on milk. Medications that are considered safe for breastfeeding The most recent research indicates that most medications can be used safely during breastfeeding.

These include (but are not limited to): Most medications for chronic conditions (such as for asthma, heart conditions, thyroid disease, high blood pressure and diabetes). Dextromethorphan has been studied in breastfeeding women and is considered safe. (Often found in Alka Seltzer Plus, Tylenol Cough & Cold, Vicks DayQuil and NyQuil and more.) Chlorpheniramine has been approved, but large doses could also lower milk supply. (Often found in Coricidin and more.). Zoloft Many mothers need to take medicines during their pregnancy and almost all medicines pass into breast milk in small quantities.

Most are generally considered safe for a mother to take but some medicines that must be avoided include lithium, cytotoxic agents, retinoids and radio-pharmaceuticals. I’m often asked by mothers who want to breastfeed about which psychiatric medication is safe. First, I want you to know that it is a myth that you must quit breastfeeding if you are going to be treated for postpartum depression.I’m always saddened to hear of moms who refuse to seek treatment because they are. The main ingredient in Benadryl is diphenhydramine while in Chlor-Trimeton is chlorpheniramine.

If you find these two active ingredients in other similar medicine, know that they could affect your mood and reduce your energy. Other than that, they are both safe for breastfeeding mothers. Can You Take Benadryl While.

Diuretics in high doses can decrease the milk supply. Among the ACE inhibitors, lisinopril is considered much safer than benazepril and captopril. Labetolol, a beta blocker often used for high blood pressure during pregnancy, is safer to continue postpartum for a breastfeeding mother than atenolol. According to the Mayo Clinic, certain allergy medicines have been determined to be safe for mothers to take while breastfeeding, such as the antihistamines Loratadine and Fexofenadine.

These antihistamines help relieve sneezing, itchy, watery eyes, runny nose and hives.

List of related literature:

Medications that are not recommended while breastfeeding include citalopram, diazepam, escitalopram, fluoxetine, lithium, nortriptyline, sertraline, and venlafaxine because of the high levels excreted in breast milk and potential risks to the infant (Sachs et al., 2013) (see also Chapter 31).

“Maternity and Women's Health Care E-Book” by Deitra Leonard Lowdermilk, Shannon E. Perry, Mary Catherine Cashion, Kathryn Rhodes Alden
from Maternity and Women’s Health Care E-Book
by Deitra Leonard Lowdermilk, Shannon E. Perry, et. al.
Elsevier Health Sciences, 2014

To prevent the passage of drugs from mother to infant, lactating mothers should avoid epinephrine, aspirin, tetracycline, ciprofloxacin (Cipro), metronidazole (Flagyl), gentamicin, vancomycin, benzodiazepines, barbiturates, and diazepam (Valium).

“Dental Hygiene E-Book: Theory and Practice” by Michele Leonardi Darby, Margaret Walsh
from Dental Hygiene E-Book: Theory and Practice
by Michele Leonardi Darby, Margaret Walsh
Elsevier Health Sciences, 2009

The following antidepressants appear to be safe for women who breastfeed: sertraline, nortriptyline, desipramine, amitriptyline, and clomipramine.

“Clinical Maternal-Fetal Medicine” by Hung N. Winn, John C. Hobbins
from Clinical Maternal-Fetal Medicine
by Hung N. Winn, John C. Hobbins
Taylor & Francis, 2000

During lactation, sertraline (Zoloft), paroxetine (Paxil), and TCAs (amitriptyline [Elavil], nortriptyline [Pamelor], and desipramine [Norpramin]) are a few preferred agents; fluoxetine must be used prudently, if at all, because of its long half-life (Gentile, 2006).

“Pharmacology for the Primary Care Provider E-Book” by Marilyn Winterton Edmunds, Maren Stewart Mayhew
from Pharmacology for the Primary Care Provider E-Book
by Marilyn Winterton Edmunds, Maren Stewart Mayhew
Elsevier Health Sciences, 2008

While sertraline (Zoloft), paroxetine (Paxil), and nortriptyline (Pamelor) are the preferred agents, in general, breastfeeding is not contraindicated with antidepressants.

“Conn's Current Therapy 2020, E-Book” by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
from Conn’s Current Therapy 2020, E-Book
by Rick D. Kellerman, KUSM-W Medical Practice Association, David Rakel
Elsevier Health Sciences, 2019

• Mothers who were being treated with a selective serotonin reuptake inhibitor, tricyclic antidepressant, or serotonin-norepinephrine uptake inhibitor during pregnancy with good symptom control should continue on the same agent during breastfeeding.

“Breastfeeding: A Guide for the Medical Profession” by Ruth A. Lawrence, MD, Robert M. Lawrence, MD
from Breastfeeding: A Guide for the Medical Profession
by Ruth A. Lawrence, MD, Robert M. Lawrence, MD
Elsevier Health Sciences, 2015

Medications compatible with breastfeeding for preventive migraine treatment include tricyclic antidepressants (amitriptyline, nortriptyline), beta-blockers (metoprolol, propranolol, bisoprolol); and when other treatment options fail, valproic acid is also acceptable.

“Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment” by Christof Schaefer, Paul W.J. Peters, Richard K Miller
from Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment
by Christof Schaefer, Paul W.J. Peters, Richard K Miller
Elsevier Science, 2014

Antidepressants that are contraindicated while breastfeeding include citalopram, escitalopram, and fluoxetine because of the high levels excreted in breast milk, their long half-life, and adverse effects on the infant (Fortinguerra, Clavenna, & Bonati, 2009).

“Maternal Child Nursing Care in Canada E-Book” by Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, Lisa Keenan-Lindsay, David Wilson, Cheryl A. Sams
from Maternal Child Nursing Care in Canada E-Book
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier Health Sciences, 2016

Medication and dosing guidelines Given the lack of teratogenicity among the TCA, SSRI, and SNRI classes, it is most important to consider a woman’s medication history when deciding which medication to use during pregnancy or lactation.

“Encyclopedia of the Neurological Sciences” by Robert B. Daroff, Michael J. Aminoff
from Encyclopedia of the Neurological Sciences
by Robert B. Daroff, Michael J. Aminoff
Elsevier Science, 2014

Sertraline (Zoloft) and paroxetine (Paxil) have shown a better neonatal safety profile during breastfeeding compared to other antidepressive drugs (Orsolini & Bellantuono, 2015).

“Breastfeeding Management for the Clinician” by Marsha Walker
from Breastfeeding Management for the Clinician
by Marsha Walker
Jones & Bartlett Learning, 2016

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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