Handal M, Matheson I
Institutt for farmakoterapi, Oslo.
Tidsskr Nor Laegeforen. 1995 Nov 20;115(28):3518-21.
Quality assurance in the care of breast-feeding women and their nursing infants also applies to drugs administered during delivery and puerperium. Large variations among hospitals may indicate that drug use is irrational. A survey comparing the extent of drug sales from the hospital pharmacy to maternity wards in eight Norwegian hospitals was performed in 1992 and the results were compared with data from 1988. The purpose was to examine whether the drug use was "baby-friendly" with regard to the following criteria; proven efficacy for the indication; no effect on milk ejection, milk production and interaction with infant; minimal transfer of drug to milk. Large variations were found among hospitals in the case of some oxytocic drugs. High use of oxytocin as nasal spray and metylergometrine as tablets may indicate unnecessary use of drugs. A large decrease (89%) in the use of hypnotics was found from 1988 to 1992, which may indicate previous irrational use of these drugs. Pethidine as pain relief during delivery remained stable during this period, and was received by 40-60% of women giving birth. None of the drugs given to the mothers was assessed to represent a risk to the breast-fed infant. In general, drug use in maternity wards had decreased during the last four years and, with some exceptions, appeared to be more baby-friendly.
对母乳喂养的妇女及其哺乳婴儿的护理质量保证也适用于分娩期和产褥期使用的药物。医院之间的巨大差异可能表明用药不合理。1992年对挪威八家医院医院药房向产科病房销售药品的情况进行了一项调查，并将结果与1988年的数据进行了比较。目的是根据以下标准检查用药是否“关爱婴儿”：对适应症有已证实的疗效；对乳汁排出、乳汁分泌无影响，且与婴儿无相互作用；药物向乳汁中的转移最少。在一些宫缩剂药物方面，各医院之间存在很大差异。催产素鼻喷雾剂和麦角新碱片剂的高使用量可能表明药物使用不当。1988年至1992年期间，催眠药的使用量大幅下降（89%），这可能表明此前这些药物使用不合理。在此期间，分娩时用作止痛的哌替啶用量保持稳定，40%至60%的产妇使用了该药。给母亲使用的药物均未被评估为对母乳喂养婴儿有风险。总体而言，在过去四年中，产科病房的用药量有所下降，并且除了一些例外情况外，似乎对婴儿更为友好。
