Volume 2, Number 4, April 1996
Assessing and Minimizing the Risk
Assessing the risk of maternal medication use in the breastfeeding infant continues to be one of the more difficult tasks faced by health care providers in obstetrics, pediatrics, and family medicine. Despite the dramatic increase in the percentage of women choosing to breastfeed, our knowledge of the safety of most medications remains limited. Research into the quantity of drug transferred into milk is complex and provides only a limited degree of certainty on the safety of medication use. However, this lack of scientific data should not lead to the conclusion that most medications are unsafe. Case reports and surveillance studies frequently provide examples of maternal medication use that does not result in adverse effects for the breastfeeding infant.
While it is important not to underestimate risk to the infant, health care providers should avoid overemphasis of potential toxicity. In a study from the MotheRisk surveillance program in Canada, the authors found that 15% of mothers given prescriptions for antibiotics failed to initiate therapy, despite being given information on the safety of these medications. Although it was not recommended to them, another 7% stopped breastfeeding during treatment. It is evident that thorough counseling, throughout lactation, is needed to allay fears and avoid maternal noncompliance or unnecessary termination of breastfeeding.