by V. Kumar

Created on: July 19, 2008   Last Updated: September 15, 2008

Mother's milk is the best nutrition for the infant. However, when the mother is taking some prescription drugs, her milk may contain those medications and the young infant will also have to endure them. The drugs that are safe for an adult are not always equally safe for a newborn child because of her limited capacity to detoxify and excrete such drugs. Thus, one needs to be aware about the drugs that can be secreted in milk and enter the child's body.

FACTORS AFFECTING SAFETY OF A MEDICATION DURING BREASTFEEDING

Not all medications are equally safe or harmful when used by a breastfeeding mother. Their safety or risk depends on a number of factors. The first of them is the age and health of the child. A premature child or a child having some disease, especially related with kidneys is at greater risk, and so requires greater precaution - even comparatively safe medicines need to be avoided to the extent possible.

The second factor that affects safety is the quantity of that drug secreted in milk. Some drugs are either not secreted in milk or secreted in such minute doses that they are unlikely to have any effect and so are considered safe. Other drugs are secreted in a greater proportion and need caution. Third factor is the duration of the action of medicines - drugs that are short acting would be safer, and their safety can also be improved by timing their intake to avoid peak concentrations during breast feeding. Last factor is the effect that the drug could have on children. For example, Aspirin can lead to a condition called 'Reye's Syndrome' in children, so it is better to avoid it. Tetracycline can stain the teeth, hence is better avoided.

ASSESSING THE NEED vs. RISK

The need for using a prescription drug to treat the mother's illness needs to be considered against the risk caused to the child. It is an expert's job and so should be done only by the prescribing physician. As a rule, in minor and self limiting conditions, medications should be avoided. If it is possible to treat the condition with topical drugs, they should be preferred over oral medication - as in case of topical anti-fungals and topical analgesics.

CATEGORISATION OF DRUGS ACCORDING TO RISK TO CHILD

Prescription drugs are categorised in different categories on the basis of their risk to child during breastfeeding. Broadly speaking, there are three categories - SAFE, which can generally be used in breastfeeding; REQUIRING CAUTION, which can be used during breastfeeding but only as per advise

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