The Transfer of Drugs and Other Chemicals Into Human Milk

Abstract

This statement was first published in 1983,1 with a revision published in 1989.2 Information about the transfer of drugs and chemicals into human milk continues to become available. This current statement is intended to revise the lists of agents transferred into human milk and describe their possible effects on the infant or on lactation, if known (Tables I through 7). The fact that a pharmacologic or chemical agent does not appear on the lists is not meant to imply that it is not transferred into human milk or that it does not have an effect on the infant; it only indicates that there were no reports found in the literature. These tables should assist the physician in counseling a nursing mother regarding breast-feeding when the mother has a condition for which a drug is medically indicated. The following question and options should be considered when prescribing drug therapy to lactating women. (1) Is the drug therapy really necessary? Consultation between the pediatrician and the mother's physician can be most useful. (2) Use the safest drug, for example, acetaminophen rather than aspirin for analgesia. (3) If there is a possibility that a drug may present a risk to the infant, consideration should be given to measurement of blood concentrations in the nursing infant. (4) Drug exposure to the nursing infant may be minimized by having the mother take the medication just after she has breast-fed the infant and/or just before the infant is due to have a lengthy sleep period. Data have been obtained from a search of the medical literature.