Pilviniene Rugile, Maciulaitis Romaldas, Jankūnas Rimas, Milvidaite Irena, Markūniene Egle
Department of Theoretical and Clinical Pharmacology, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2006;42(12):1035-45.
Breastfeeding is the most healthful method of feeding neonates and infants. In 2001 about 98% of new mothers in Lithuania started breastfeeding their neonates. One-third of nursing women (34%) discontinued breastfeeding at the time when infant reached the age of 3 months. About 56% of women breastfed their infants longer than 4 months. Only 3-6% of nursing women discontinued breastfeeding after the fourth month. Discontinuation of breastfeeding in 21-23% of all cases was directly or indirectly associated with use of medications. Such data suggest that there is a lack of information often leading physicians to advise mothers to discontinue breastfeeding because of medication use. The aim of this article was to survey the situation about classification of drugs used during breastfeeding and factors influencing drug transfer into milk in order to give more information for physician concerning the use of medication during breastfeeding. In this review, a short description of main pharmacokinetic characteristics, influencing drug transfer into milk; information on the classification of drugs used during breastfeeding; some considerations on drug safety and possible adverse effects of medications on breastfed infant; the list of drugs preferred for nursing women are presented.
母乳喂养是喂养新生儿和婴儿最健康的方式。2001年,立陶宛约98%的新妈妈开始对其新生儿进行母乳喂养。三分之一的哺乳期女性(34%)在婴儿3个月大时停止母乳喂养。约56%的女性母乳喂养婴儿的时间超过4个月。只有3 - 6%的哺乳期女性在第4个月后停止母乳喂养。在所有案例中,21 - 23%的母乳喂养中断直接或间接与用药有关。这些数据表明,信息缺乏常常导致医生因母亲用药而建议其停止母乳喂养。本文的目的是调查母乳喂养期间所用药物的分类情况以及影响药物进入乳汁的因素,以便为医生提供更多关于母乳喂养期间用药的信息。在这篇综述中,介绍了影响药物进入乳汁的主要药代动力学特征的简短描述;母乳喂养期间所用药物的分类信息;关于药物安全性以及药物对母乳喂养婴儿可能产生的不良反应的一些考量;哺乳期女性首选药物清单。