Rational use of medication during breastfeeding to protect baby's safety

May 20th, which just passed, was the National Breastfeeding Promotion Day. In 2021, the National Health Commission issued the "Breastfeeding Promotion Action Plan (2021-2025)" to ensure the implementation of optimized fertility policies, safeguard the rights and interests of mothers and infants, and promote breastfeeding. Lactoferrin, carbohydrates, proteins, fats, vitamins, etc. contained in breast milk are the main sources of nutrients for newborns, which contribute to the growth and development of babies and improve their ability to resist diseases. However, most drugs can also be absorbed by babies through breast milk, so many mothers have trouble with medication during lactation. How to find a balance between treating diseases and breastfeeding? By answering the following common questions, Yaowa helps mothers to correctly choose relevant treatment drugs.

Question 1

Can all medicines be absorbed by the baby through breast milk?

—— Analysis by Yaowa——

There are many factors that affect the transport of drugs through breast milk, which mainly depends on the physical and chemical properties of the drug, the plasma protein binding rate of the drug, the blood drug concentration in the mother's body, etc. It is worth noting that almost all drugs can enter breast milk and be absorbed by the baby, but the degree of absorption is different. Therefore, medications should be selected carefully during lactation.

Question 2

Should I try to avoid taking medicine during breastfeeding?

—— Analysis by Yaowa——

In principle, medication should be avoided during breastfeeding. However, if medication is necessary for the sake of maternal health after weighing the pros and cons, breastfeeding should be suspended or reduced during medication. Drugs with high safety and low breast milk discharge should be selected, and medication should be taken during breastfeeding from 30 minutes after breastfeeding to 3 to 4 hours before the next breastfeeding. Breastfeeding mothers can choose to take medication just after breastfeeding, and extend the time of the next breastfeeding as much as possible to avoid the peak period of the drug in breast milk.

Question 3

If drug treatment is necessary, how do you choose safe drugs?

—— Analysis by Yaowa——

In "Medications and Breastfeeding (17th Edition)", breastfeeding drugs are divided into five levels from L1 to L5 according to the safety of the drugs. Mothers should try to choose L1 and L2 level drugs, which are relatively safe, under the guidance of doctors and pharmacists. They do not need to stop breastfeeding when using them, but they should pay attention to the interval between taking the medicine and breastfeeding. Breastfeeding should be stopped during the use of L4 and L5 drugs.

Question 4

What other precautions should be taken when taking medication during breastfeeding?

—— Analysis by Yaowa——

1. Weigh the pros and cons and make a comprehensive assessment. Since almost all drugs can enter breast milk and be absorbed by the baby, it is not necessary to take drugs during breastfeeding. If medication is necessary based on the condition, you should choose a safe drug under the guidance of a doctor.

2. Choose the best medicine with the appropriate dosage form. Follow the doctor's advice and the drug instructions, try to choose medicines with a single ingredient and use small doses. Oral administration is safer than intravenous administration. Intravenous administration has no absorption process and directly enters the blood circulation, which has a greater impact on infants.

3. Pay attention to the timing and observe closely. When medication is necessary, you need to stop breastfeeding for a few hours or days under the guidance of a doctor or pharmacist. Because the baby's discomfort cannot be reported in time, the adverse reactions of some drugs are mainly manifested in damage to liver and kidney function, immune and endocrine function, etc., which cannot be observed in time and need to be confirmed by laboratory indicators. Therefore, during medication, it is necessary to closely observe the baby's physical signs and seek medical attention in time if any discomfort is found.