Breastfeeding is beneficial for both mother and child. New mothers are encouraged to breastfeed for 6 months exclusively and continue to breastfeed while other food sources are introduced until the child is at least two years old. During the postpartum period, many new mothers need medicines. Because of a lack of information on medicine safety for the nursing infant and child, many women choose to stop breastfeeding to protect their babies. But maternal drug intake only rarely requires interruption of breastfeeding.
While most drugs transfer from the mother’s blood into her breastmilk, her child usually ingests only a very small amount when nursing. The evidence available to support informed decision-making is scarce, and the evidence that does exist relies on few clinical studies and prediction models. The ConcePTION project is working to provide more precise answers to mothers’ and health care professionals’ questions about medicines and nursing. It is not uncommon that women are advised to stop breastfeeding to start a medical treatment.
Women will always be concerned for their children. Healthcare professionals should keep this in mind when they are conveying risk information about medicine use and breastfeeding. When someone wants to breastfeed, but also needs a treatment, risk information should be provided appropriately. The authors of a recent publication in Therapies emphasise the need for specialized sources of information written by experts to help guide women and healthcare professionals in decisions about medicine use and breastfeeding.
This is the main risk factor for adverse reactions in the child. Central to such a benefit-risk assessment is the potential for the accumulation of a drug in the infant’s system.
“Breast milk is the best nourishment for babies. And breastfeeding is such a delicate process that even stopping for a weeklong antibiotic treatment, and hoping baby takes the bottle, can completely disrupt the lactation process. Which is why, given the benefits associated for both the mother and child, it is important not to advise women to stop breastfeeding when they need treatment before conducting a thorough benefit-risk assessment for both mother and child,” says Alice Panchaud, clinical pharmacist at Lausanne University Hospital and Professor in Pharmacy at Universität Bern, and one of the authors of the paper.
When a woman decides to use a drug during breastfeeding, this should be based on a favourable benefit-risk analysis for both the mother and the infant. According to Alice Panchaud and her co-authors, unnecessary interruptions of breastfeeding and delays of required treatments should be prevented, for the sake of both women and children.
By Anna Holm Bodin
Cardoso,E., Montford, A., Ferreira, E., Norgeng, H., Winterfeld, U., Allegaert, K., Gandia, P., Guidi, M., & Panchaud, A. (2023) Maternal drugs and breastfeeding: Risk assessment from pharmacokinetics to safety evidence – A contribution from the ConcePTION project, Therapies 78(2), DOI: 10.1016/j.therap.2023.01.008