Effects on the infant of drug therapy in nursing mothers
Knowles, J.A.
Drug Therapy 3(5): 57-59; 65
1973
ISSN/ISBN: 0001-7094 PMID: 12262536 Document Number: 517644
The effects of maternal intake while nursing of anticoagulants, antimicrobials, psychopharmacologicals, steroids, thyroid and antithyroid preparations, and miscellaneous drugs, such as cathartics, fluoride, phenylalanine, and radioactive substances, on the infant are enumerated. Mothers taking anticoagulants should not breastfeed because of potential life-threatening hemorrhages in nursing infants. The level of antibiotics in maternal milk is generally so low as to be innocuous. However, the possibility of later allergic reaction in the infant should be considered. Levels of chloramphenicol, erythromycin, naladixic acid, nitrofurantoin, penicillin, streptomycin, and sulfonamides are so low as to be of little significance; however, metronidazole is excreted in breast milk and its effects on newborns are unknown at present; this drug is therefore contraindicated in nursing mothers. No effect on a nursing infant is found with maternal ingestion of alcohol, chlorpromazine, propoxyphene hydrochloride, and diphenylhydantoin; however, codeine, heroin, and morphine, although difficult to find in milk, may cause infant withdrawal symptoms. Phenobarbital and primidone are contraindicated. Oral contraceptives decrease lactation, but transfer effect is unknown. Theouracil is one of the few drugs that is found in higher amounts in mother's milk than in serum. Minute amounts of radioactive products, steroids, anticoagulants, and antineoplastics can cause profound infant effects, and nursing mothers should discontinue nursing if these medications are necessary.