Bioavailability
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the fraction of administered drug that reaches the systemic circulation
(depends on the route- oral, IV, subq, topical, IM)
many meds do not pose a risk to the infant- topical do not get absorbed
into plasma, oral meds get metabolized by the liver and do not enter
plasma
Radioactive agents
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, brief half lives
mother can pump and discard milk for 12-24 hours and continue to
breastfeed
some radioisotopes may require longer waiting periods or cessation of
breastfeeding
Iodine-131 is the most dangerous radioisotope
most commonly used pharmaceutical galactogogues at present
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Domperidone and metoclopramide
Both are dopamine antagonists that increase prolactin secretion
Why are Galactogogues used?
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to increase low (or perceived low) milk supply
in mothers with preterm infants, where the aim has been to stimulate initial
secretory activation or augment declining milk secretion
Mothers who are not breastfeeding, but are expressing milk by hand or
with a pump
in women inducing lactation when they have not been pregnant with the
current child, in women relactating after weaning, or in transgender women
Hormonal methods should be discouraged in some circumstances
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, 1. existing low milk supply or history of lactation failure
2. history of breast surgery
3. multiple birth (twins, triplets)
4. preterm birth
5. compromised health of mother and/or baby
medical causes of low milk supply:
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pregnancy, medications, primary mammary glandular insufficiency, breast
surgery, polycystic ovarian syndrome, hypothyroidism, retained placenta,
ingestion of placenta capsules, theca lutein cyst, loss of prolactin secretion
following postpartum hemorrhage, heavy smoking or alcohol use, or other
pertinent conditions.
drug transfer to milk
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early stages of lactation- the lactocytes are small in size and the
intracellular spaces are large causing maternal substances such as drugs,
lymphocytes, immunoglobulins, proteins and other plasma substances to
transfer into human milk
lactocytes will grow and close junctions between cells at 36 hours post
delivery
Should mothers exposed to drugs and alcohol breastfeed?
Give this one a try later!
Give this one a try later!
the fraction of administered drug that reaches the systemic circulation
(depends on the route- oral, IV, subq, topical, IM)
many meds do not pose a risk to the infant- topical do not get absorbed
into plasma, oral meds get metabolized by the liver and do not enter
plasma
Radioactive agents
Give this one a try later!
, brief half lives
mother can pump and discard milk for 12-24 hours and continue to
breastfeed
some radioisotopes may require longer waiting periods or cessation of
breastfeeding
Iodine-131 is the most dangerous radioisotope
most commonly used pharmaceutical galactogogues at present
Give this one a try later!
Domperidone and metoclopramide
Both are dopamine antagonists that increase prolactin secretion
Why are Galactogogues used?
Give this one a try later!
to increase low (or perceived low) milk supply
in mothers with preterm infants, where the aim has been to stimulate initial
secretory activation or augment declining milk secretion
Mothers who are not breastfeeding, but are expressing milk by hand or
with a pump
in women inducing lactation when they have not been pregnant with the
current child, in women relactating after weaning, or in transgender women
Hormonal methods should be discouraged in some circumstances
Give this one a try later!
, 1. existing low milk supply or history of lactation failure
2. history of breast surgery
3. multiple birth (twins, triplets)
4. preterm birth
5. compromised health of mother and/or baby
medical causes of low milk supply:
Give this one a try later!
pregnancy, medications, primary mammary glandular insufficiency, breast
surgery, polycystic ovarian syndrome, hypothyroidism, retained placenta,
ingestion of placenta capsules, theca lutein cyst, loss of prolactin secretion
following postpartum hemorrhage, heavy smoking or alcohol use, or other
pertinent conditions.
drug transfer to milk
Give this one a try later!
early stages of lactation- the lactocytes are small in size and the
intracellular spaces are large causing maternal substances such as drugs,
lymphocytes, immunoglobulins, proteins and other plasma substances to
transfer into human milk
lactocytes will grow and close junctions between cells at 36 hours post
delivery
Should mothers exposed to drugs and alcohol breastfeed?
Give this one a try later!
