Medications and Breastmilk.

While many mothers never have to worry about drug compatibility during breastfeeding, it is a frequent concern. Breastfeeding mothers must realize that many physicians, including pediatricians, are not aware of the most accurate information. Mothers have many options when faced with a medication choice:

Use non-medicinal treatments
Use appropriate resources to determine the safest medication
Only if the first two options have been exhausted, regulate or discontinue breastfeeding

Only in rare instances is it impossible to find a drug compatible with breastfeeding. It is not a trivial thing to deny a baby the benefits of breastmilk. When a mother is informed by her doctor that she must discontinue breastfeeding, the wise mother asks her doctor what reference was consulted. The Physician's Desk Reference, or P.D.R., while readily available, is not an appropriate resource since it is complied from information supplied by the drug companies. The information in the P.D.R. is overly conservative in regards to lactation since the pharmaceutical companies wish to shield themselves from liability where they cannot rigorously test a drug, such was with pregnant and lactating women.

The mother can research her options in the following resources and bring her information to her doctor.

Hale, Thomas W., Medications and Mother's Milk 1998-1999, 7th ed. (Amarillo, TX: Pharmasoft Medical Publishing, 1998). Dr. Hale also has a website that is very informative. This is the most extensive and up-to-date resource.
Briggs, GG, Freeman, RK, and Yaffe, SJ, Drugs in Pregnancy and Lactation, 4th ed. (Baltimore: Williams & Wilkins, 1994). An excellent resource, although due for a revision.
American Academy of Pediatrics, Committee on Drugs, "The transfer of drugs and other chemicals into human milk." Pediatrics, 93 (1994), 137-150. This document is also available on-line, and is also a little out-dated.

So, if your physician tells you that you and your baby must give up breastfeeding for your sake, do the research and persevere--you will most likely be able to find a solution that saves breastfeeding for you.

References.

In addition to the above resources, the following edition of the P.D.R. was consulted:

Medical Ecomonics Data, Physician's Desk Reference, 47th ed. (Montvale, N.J.: Medical Economics Data, 1993), forward.

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