After Pregnancy - Drugs Used During Breastfeeding- Effects on Newborn Baby

After Pregnancy - Drugs Used During Breastfeeding- Effects on Newborn Baby

Before prescribing any medication to a lactating mother pediatrician should consider the following conditions:

a.       Is drug therapy absolutely necessary

b.      Whether infant has got ability to metabolize the medication

c.       How far we can minimize drug exposure to infant

d.      The pharmacokinetics of the drug

e.      Will the drug interact with the medication the infant is prescribed, whether the drug may have adverse effect in the nursing infants and lastly

f.        To choose the safest drug as far as possible

Types of Drugs Prescribed

Cytotoxic Drug- after Pregnancy

Cyclophosphamide, cyclosporine, doxorubicin and methotrexate, etc. were thought to interfere with cellular metabolism in nursing infants. Immune-suppression, and neutropenia may cause in the nursing infant Effects of growth and carcinogenesis are not known.

Drug of Abuse- After Pregnancy

Amphetamine, cocaine, heroin, marijunana, phencyclidine may lead to poor sleeping and irritability- vomiting, diarrhea, tremors, seizures, restlessness, poor feeding, decreased weight gain in infants and possible increased respiratory illness in the infants.

Psychotropic Drugs- After Pregnancy

Antianxiety, Antidepression, Antipsychotic drugs. These drugs usually appear in breast milk in low concentration leads to limited adverse effects in infants but its long-term effects although unknown but colic, irritability, feeding and sleep disorders and slow weight gain are reported with fluoxetine, chlorpromazine may lead to drowsiness and lethargy and declining development score has been reported.

Padioactive Compounds- After Pregnancy

Drug like copper 64, ¹³¹ I, etc. when prescribed in a nursing mother is better to be avoided. A short acting radio nucleotide may be appropriate. It is very much important to screen milk samples, to find out any radioactive drugs in the milk before receiving feeding.

Other Drugs- After Pregnancy

Amiodarone may cause hypothyroidism, cholraphenicol leads to idiosyncratic bone marrow suppression. Metronidazole and tinidazole are in vitro mutagenic agents. Clofazimine may increase skin pigmentation. Atenolol cause cyanosis and bradycardia. Phonobarbitone may lead to sedation, infantile spasm and methemogloginemia and ergotamine may cause vomiting, diarrhea and convulsions.