What medicine to take for internal heat during breastfeeding

Many mothers will feel very anxious if they get a sore throat during breastfeeding, because they cannot take anti-inflammatory drugs at this time, and even many Chinese herbal medicines for reducing heat should not be taken indiscriminately. This is related to whether they can still breastfeed their babies. If they have already taken the medicine, they need to stop breastfeeding for a period of time, and try to take some foods that have heat-clearing and detoxifying effects to improve the situation.

Because most of the drugs taken by nursing mothers can be excreted from breast milk, the concentration of some drugs such as erythromycin and thiouracil in breast milk is higher than that in the mother's blood, and the baby will ingest the drugs while feeding. Because the drug absorption and metabolism process of infants is still immature, the metabolism and excretion of drugs in the body are slow and they tend to accumulate in the body. Therefore, nursing mothers must be cautious when taking medication.

Almost all drugs can be transferred into breast milk through the plasma-milk barrier, and breastfeeding infants can suck 800-1000 ml of milk every day. Therefore, the use of medication during lactation should also be taken seriously. Factors that affect drug transfer into breast milk include:

1. Route of administration: The time when the peak value of the drug in maternal blood appears is different. For example, after intravenous administration of antibiotics, a peak level appears immediately in the maternal blood. Oral administration varies depending on the medicine. It usually takes 60 to 120 minutes for the peak to appear. The peak value in milk generally appears 30-120 minutes later than that in plasma, and its peak value generally does not exceed that in plasma. The drug elimination rate in breast milk decreases over time, but at a slower rate than that in plasma.

2. pH of the drug: The pH of maternal blood is 7.35-7.45, and the pH of breast milk is 6.35-7.30. Practice has shown that weak alkaline drugs such as erythromycin, lincomycin, and isoniazid can easily pass through the plasma-milk barrier. After administration, the drug concentration in breast milk can be the same as that in plasma, or even higher than that in plasma. On the contrary, weakly acidic drugs such as penicillin and sulfonamides are not easy to pass through the barrier, and the drug concentration in breast milk is often lower than that in plasma.

3. Lipid solubility: Drugs with strong lipid solubility are often non-ionic, easily pass through lipid-rich cells, and dissolve in the fat of breast milk; drugs with low lipid solubility are difficult to transport into breast milk even if they are non-ionic.

4. Plasma protein binding rate: After the drug binds to plasma protein, it is difficult to pass through the biological membrane. Therefore, the concentration of free drugs affects the transport of drugs into breast milk. For example, sulfonamides with a high protein binding rate and oxacillin sodium are difficult to transport into breast milk.

5. Molecular weight: Drugs with molecular weight <200, such as alcohol, morphine, and tetracycline, can be transported from plasma to breast milk by simple diffusion, while high molecular weight compounds such as heparin and insulin are difficult to transport into breast milk.