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哺乳期用药:是导致早期断奶的潜在因素,还是对母婴对子的循证支持?

Medication Use During Lactation: Either a Potential Contributor to Premature Weaning or Evidence-based Support of the Mother/Child Couplet.

机构信息

Obstetrics, Gynecology and Breastfeeding Medicine, MGH Lactation Clinic, Massachusetts General Hospital, 55 Fruit St, Founders 430, Boston, MA, 02114, USA.

出版信息

Clin Ther. 2020 Mar;42(3):393-400. doi: 10.1016/j.clinthera.2020.01.019. Epub 2020 Feb 26.

Abstract

It is well established that breastfeeding improves the health of women, children, and populations. According to the 2018 Centers for Disease Control and Prevention Report Card, 83% of women initiated breastfeeding, but only 58% maintained breastfeeding at the 6-month mark, and 36% continued to 12 months. Reasons for cessation of breastfeeding are multifactorial and include issues surrounding safe use of medications while breastfeeding for acute or chronic conditions. There are a wide variety of resources that clinicians may consult to help decide if medications are compatible with breastfeeding. The resources have varying data and recommendations, which can make counseling challenging for the clinician. There are some resources that are updated regularly with the most current information about drug safety in lactation, as well as call centers that can answer questions from clinicians and patients. A case scenario is presented to help illustrate the many facets of how medication use can affect breastfeeding. Very few medications are absolutely contraindicated during lactation. Involving the woman and her family in a shared decision-making approach regarding medication use may help women feel more confident in the medication recommendations given and ultimately help women achieve their breastfeeding goals. (Clin Ther. 2020; 42:XXX-XXX)© 2020 Elsevier HS Journals, Inc.

摘要

众所周知,母乳喂养有益于妇女、儿童和人群的健康。根据 2018 年疾病控制与预防中心的报告卡,83%的女性开始母乳喂养,但只有 58%的女性在 6 个月时仍坚持母乳喂养,36%的女性持续母乳喂养到 12 个月。母乳喂养中断的原因是多方面的,包括在急性或慢性疾病期间安全使用药物的问题。临床医生可能会咨询各种资源来帮助决定药物是否与母乳喂养兼容。这些资源的数据和建议各不相同,这使得临床医生的咨询具有挑战性。有些资源会定期更新关于哺乳期药物安全性的最新信息,以及可以回答临床医生和患者问题的呼叫中心。提出一个案例情景来帮助说明药物使用如何影响母乳喂养的许多方面。非常少的药物在哺乳期绝对禁忌。让妇女及其家人参与关于药物使用的共同决策方法可能有助于妇女对所提供的药物建议更有信心,并最终帮助妇女实现母乳喂养目标。(临床治疗。2020; 42:XXX-XXX)©2020 Elsevier HS 期刊,公司。

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