MEDICATION IN LACTATION

There are few medications that would cause someone to stop breastfeeding (see contraindications page). NICE Guidance recommends that health professionals prescribing in lactation must consult supplementary sources on the benefits and risk (rather than relying on the British National Formulary, which does not at present contain sufficient data to base individual decisions)

 

Please look at these trusted resources before advising anyone to stop breastfeeding due to medication:

UKDILAS - this is an NHS advisory service on lactation and drugs. Specialist lactation information is available on individual drugs - search for the drug and then scroll right down to the bottom to see the lactation section (or click on the 'lactation safety information' hyperlink to jump straight there). There are also topic reviews and Q&As on broader classes of medication. Health professionals can contact the enquiry service in working hours on 0116 258 6491, 0121 4247298, ukdilas.enquiries@nhs.net or @ukdilas. Of particular relevance are the information sheets on:

 

LactMed - this is a searchable database from the US National Library of Medicine

The Royal College of Radiologists includes breastfeeding in their guideline on gadolinium-based contrast, stating that a very small percentage of the injected dose enters breastmilk and virtually none is absorbed by a normal infant gut - therefore no special precaution or cessation of breastfeeding is required related to gadolinium-based contrast. The Royal College of Radiologists also endorses the Royal Australian and New Zealand College of Radiologists' guideline on iodenated contrast agents, which states that "cessation of breast feeding or expression and discarding of breast milk after iodinated contrast media administration are not required"

The Association of Anaesthetists has a guideline on anaesthesia and sedation in breastfeeding women

The Academy of Breastfeeding Medicine has protocols on analgesia and anaesthesia, and substance misuse, amongst others

The Breastfeeding Network (BfN) medication factsheets and the Drugs in Breastmilk Helpline - compiled and run on a voluntary basis by Dr Wendy Jones, who has been awarded a Prime Minister's "Points of Light" award and an MBE for this work. Families and health professionals can email or message on the Facebook page. Of particular relevance are the factsheets on:

The Royal College of Obstetrics & Gynaecology has issued specific guidance on codeine in breastfeeding mothers, which recommends that dihydrocodeine should be used in preference due to the risk of opiate toxicity to the newborn in some people taking codeine. This information is taken from the UKDILAS Q&A on weak opiates

Also see our resources for HIFN campaign 'Don't Say Stop Look it Up'

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Thank you for visiting the Hospital Infant Feeding Network. This website is a repository of relevant knowledge and best practice resources for health professionals. To join the conversation, ask questions and share your experiences please join us on Facebook or Twitter.

 

We will be running Q&A sessions on various topics, which will be advertised on our social media sites. Please email if you have ideas or want to get more involved. We welcome health professionals passionate about supporting breastfeeding in the hospital setting to join our steering group, please get in contact if this is you!

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