What drugs can pass through breast milk?

Understanding Drug Transfer Through Breast Milk
The transfer of drugs into breast milk is a complex process influenced by various pharmacological properties of the drugs themselves. While nearly all medications can be detected in breast milk to some degree, the extent of this transfer varies significantly based on several factors.
Key Factors Influencing Drug Transfer
1. Molecular Size and Structure: The size of the drug molecule plays a crucial role in its ability to cross into breast milk. Larger molecules, such as insulin and heparin, are generally too big to pass through the biological barriers into breast milk, making them safe for breastfeeding mothers.
2. Protein Binding: Drugs that are highly bound to plasma proteins tend to have lower concentrations in breast milk. For instance, medications like sertraline, which have a high volume of distribution, result in lower maternal plasma concentrations and subsequently lower concentrations in milk. This means that the more a drug binds to proteins in the bloodstream, the less likely it is to be found in breast milk.
3. Lipid Solubility: Lipid-soluble drugs are more likely to pass into breast milk. This is due to the fat content of breast milk, which can trap these substances. Weakly basic drugs, such as barbiturates and possibly lithium, can concentrate in milk at higher ratios compared to their plasma concentrations.
4. Ionization: The ionization state of a drug also affects its transfer into breast milk. Drugs that are non-ionized at physiological pH are more likely to diffuse into breast milk.
Common Drugs and Their Safety Profiles
While many medications can be detected in breast milk, some are considered safer than others. For example, insulin is not excreted into breast milk and is deemed safe for breastfeeding mothers. Similarly, certain first-generation sulfonylureas, like tolbutamide, are also compatible with breastfeeding.
On the other hand, substances like alcohol and nicotine can pass into breast milk and may pose risks to the infant. Recommendations suggest limiting alcohol intake to no more than three cups of coffee per day and avoiding smoking altogether.
Recommendations for Breastfeeding Mothers
For mothers who need to take medication while breastfeeding, it is crucial to consult healthcare providers to evaluate the safety of specific drugs. In cases where a drug poses a risk to the infant, mothers may be advised to temporarily stop breastfeeding until the drug is cleared from their system.
In summary, while many drugs can pass through breast milk, the degree of transfer is influenced by their molecular characteristics, and some medications are safer than others. Mothers should always seek professional guidance when considering medication use during breastfeeding to ensure the health and safety of their infants.

What happens if you breastfeed with drugs in your system?

There is still a lot we don’t know about the effects of drugs on your baby when you are breastfeeding but it’s thought that, even at low levels, taking drugs is likely to: make your baby drowsy, feed poorly and have disturbed sleep patterns and poor weight gain. cause behavioural problems.

When is it not safe to breastfeed?

There are a few medical contraindications to breastfeeding, and these include: An infant who has the metabolic disorder of classic galactosemia (galactose 1-phosphate uridyltransferase deficiency). A mother living with human T-cell lymphotrophic virus type I or type II.

Which drugs are excreted in milk?

• analgesics and antipyretics: short courses of paracetamol, acetylsalicylic acid, ibuprofen;
• antibiotics: ampicillin, amoxicillin, cloxacillin and other penicillins, erythromycin.
• bronchodilators (e.g. salbutamol), corticosteroids, antihistamines, antacids.

What drugs can be passed through breast milk?

Most drug molecules, including alcohol, nicotine and caffeine, are small enough to enter milk. Exceptions are drugs with high molecular weights such as heparins and insulin.

What substances can pass through breast milk?

A woman’s lifestyle may affect her breast milk, and have an impact on the baby. During breastfeeding, it is important for a woman not to consume alcohol, smoke, or take drugs. These substances are known to pass through the breast milk.

Which drugs cannot be taken when breastfeeding?

ANSWER: Only a few drugs pose a clinically significant risk to breastfed babies. In general, antineoplastics, drugs of abuse, some anticonvulsants, ergot alkaloids, and radiopharmaceuticals should not be taken, and levels of amiodarone, cyclosporine, and lithium should be monitored.

Which drugs are affected by milk?

Common dairy product interactions include certain antibiotics, such as tetracyclines and fluoroquinolones, osteoporosis medications, and iron supplements. Levothyroxine (Synthroid, Unithroid), lithium (Lithobid), and HIV medications also interact with dairy products.

What happens if you test positive for drugs as a nurse?

Depending on the severity of the situation and the provider’s history, this could range from probation, referral to a peer assistance program, temporary suspension of the license, or even revocation.

What passes through breast milk to a baby?

Foods and drinks to avoid while breastfeeding
Caffeine passes into breastmilk, so large amounts of tea, coffee and cola drinks are best avoided. Drinking small amounts of drinks with caffeine (3 or less drinks a day) should not be a problem. Alcohol also passes into breastmilk and can affect your baby.

How long does oxycodone stay in breastmilk?

Conclusions: Oxycodone is concentrated in human breast milk up to 72-h post-partum. Breastfed infants may receive > 10% of a therapeutic infant dose. However, maternal oxycodone intake up to 72-h post-CS poses only minimal risk to the breast-feeding infant as low volumes of breast milk are ingested during this period.