The Transfer of Drugs and Other Chemicals Into Human Milk
AMERICAN ACADEMY OF PEDIATRICS Committee on Drugs
PEDIATRICS Vol. 108 No. 3 September 2001
The American Academy of Pediatrics places emphasis on increasing breastfeeding in the United States. A common reason for the cessation of breastfeeding is the use of medication by the nursing mother and advice by her physician to stop nursing. Such advice may not be warranted. This statement is intended to supply the pediatrician, obstetrician, and family physician with data, if known, concerning the excretion of drugs into human milk. Most drugs likely to be prescribed to the nursing mother should have no effect on milk supply or on infant well-being. This information is important not only to protect nursing infants from untoward effects of maternal medication but also to allow effective pharmacologic treatment of breastfeeding mothers. Nicotine, psychotropic drugs, and silicone implants are 3 important topics reviewed in this statement.
A statement on the transfer of drugs and chemicals into human milk was first published in 1983,1 with revisions in 19892 and 1994.3 Information continues to become available. The 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 1-7). If a pharmacologic or chemical agent does not appear in the tables, it does not mean 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 breastfeeding when the mother has a condition for which a drug is medically indicated.
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