Hagemann T M
Department of Pharmacy Practice, University of Oklahoma College of Pharmacy, Oklahoma City 73190, USA.
J Hum Lact. 1998 Sep;14(3):259-62. doi: 10.1177/089033449801400321.
Medications used to treat gastrointestinal symptoms are increasingly being used as more have been gained nonprescription status. Most of the gastrointestinal medications, such as laxatives, antacids, and antidiarrheal agents, are used short term. Women who breastfeed should be aware of the risks of taking any medications, whether prescription or nonprescription. There is little information describing transfer into breast milk for many of these products. Cimetidine, atropine, cascara, cisapride, loperamide, magnesium sulfate, and senna are the only products identified by the AAP as compatible with breast feeding. Metoclopramide is listed by the AAP as a drug whose effect on nursing infants is unknown but may be of potential concern, although studies published to date have not reported any adverse effects. The safest laxatives and antidiarrheals are those that are not absorbed and should be considered first-line therapy for conditions of constipation or loose stools. Famotidine and nizatidine are excreted into breast milk to a lesser extent than cimetidine or ranitidine and may be the preferred histamine antagonists. Despite the limited data on the use of cisapride in nursing women, it is considered safe by the AAP and may be preferred over metoclopramide for first-line prescription treatment of heartburn. Although most of these agents appear safe in the nursing infant, caretakers should be aware of the potential adverse reactions that may occur in infants whose mothers require these products.
随着越来越多治疗胃肠道症状的药物获得非处方状态，其使用也日益广泛。大多数胃肠道药物，如泻药、抗酸剂和止泻剂，都是短期使用。哺乳期妇女应意识到服用任何药物（无论是处方药还是非处方药）的风险。关于许多此类产品进入母乳的信息很少。西咪替丁、阿托品、番泻叶、西沙必利、洛哌丁胺、硫酸镁和番泻叶是美国儿科学会（AAP）确定的仅有的与母乳喂养相容的产品。甲氧氯普胺被AAP列为一种对哺乳婴儿的影响未知但可能存在潜在问题的药物，尽管迄今为止发表的研究尚未报告任何不良反应。最安全的泻药和止泻剂是那些不被吸收的药物，应被视为便秘或腹泻情况的一线治疗药物。法莫替丁和尼扎替丁分泌到母乳中的程度低于西咪替丁或雷尼替丁，可能是首选的组胺拮抗剂。尽管关于西沙必利在哺乳期妇女中的使用数据有限，但AAP认为其安全，并可能比甲氧氯普胺更适合作为烧心一线处方治疗药物。尽管这些药物大多在哺乳婴儿中似乎是安全的，但护理人员应意识到母亲需要这些产品的婴儿可能会出现的潜在不良反应。
