Nunez-Pellot Cristina, Akers Allison, Običan Sarah, Cain Mary Ashley, Crousillat Daniela R
Division of Cardiovascular Sciences, Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Am Heart J Plus. 2025 May 8;55:100552. doi: 10.1016/j.ahjo.2025.100552. eCollection 2025 Jul.
Breastfeeding is the gold standard for infant feeding with well-established maternal, neonatal, and pediatric benefits. Patients with preexisting cardiovascular disease have lower breastfeeding rates than the general population. While little evidence exists regarding specific barriers to lactation in patients with preexisting cardiovascular disease, concerns regarding lactation safety and medication exposure in mothers with cardiovascular disease may be a cause for early breastfeeding cessation despite known health benefits. This literature review highlights the lactation safety of common cardiac medications. While some common cardiac medications may have limited safety data available, general pharmacokinetic principles of drug secretion in lactation can help to guide shared decision making in discussion with the patient. Enhancing provider knowledge regarding cardiac medication safety during breastfeeding may improve lactation outcomes in this population.
母乳喂养是婴儿喂养的金标准，对母亲、新生儿和儿童均有公认的益处。患有心血管疾病的患者母乳喂养率低于普通人群。虽然关于患有心血管疾病的患者哺乳的具体障碍的证据很少，但对患有心血管疾病的母亲的哺乳安全性和药物暴露的担忧可能是导致早期停止母乳喂养的原因，尽管母乳喂养有已知的健康益处。这篇文献综述强调了常用心脏药物的哺乳安全性。虽然一些常用心脏药物的安全性数据有限，但药物在哺乳期分泌的一般药代动力学原理有助于指导与患者讨论时的共同决策。加强医疗服务提供者对母乳喂养期间心脏药物安全性的认识可能会改善该人群的哺乳结局。
