Traducciondefinitvamedicamentos.pdf

Policy Statement
Pediatrics
Volume 108, Number 3
September 2001, pp 776-789
El Paso de medicamentos y otros productos químicos a la leche
materna
AMERICAN ACADEMY OF PEDIATRICS
RESUMEN. La Academia Americana de Pediatría tiene como objetivo incrementar las tasas de
lactancia materna en los Estados Unidos de América. Un motivo común para el cese de la lactancia
materna es el uso de medicación por la madre que lacta y el consejo de su medico que deje de
lactar. Esta declaración fundamentada suministra al pediatra, obstetra y medico de familia el
conocimiento actualizado sobre la excreción de medicamentos en la leche humana. La mayoría de
los medicamentos que se prescriben a la madre que lacta no tiene efecto sobre la lactancia o el
bienestar del niño. Esta información es importante no sólo para proteger a los niños lactados de
efectos adversos de la medicación materna sino porque también permite el efectivo tratamiento
farmacológico de la madre que lacta. Nicotina, Drogas Psicotropas e implantes de silicona son tres
importantes temas revisados en esta declaración.
INTRODUCCION
Una declaración sobre el paso de medicamentos y productos químicos a la leche humana fue publicadapor primera vez en 1983 1, con revisiones en 1989 2 y 1994 3. La información continua disponible. EstaDeclaración actual tiene la intención de revisar la lista de agentes que pasan a través de la leche humana ydescribir los posibles efectos sobre el niño o sobre la lactancia, si se conocen, ( tablas 1-7) Si un productofarmacológico o agente químico no aparece en las tablas, ello no significa que no pase a la leche humanao que no tenga efecto sobre el lactante, ello sólo indica que no hay estudios publicados en la literatura.
Estas tablas deben de asistir al medico en el consejo a la madre que lacta con relación a la lactanciamaterna cuando la madre tiene una condición a consecuencia de la cual el medicamento esta indicado LACTANCIA MATERNA Y EL TABACO
En ediciones previas de esta declaración, el Comité de Medicamentos colocó la nicotina (Tabaquismo) enla Tabla 2, " Drogas de Abuso para la que se describen Efectos adversos sobre el Lactante." Las razonespara colocar nicotina y, de esa manera, Tabaquismo en la Tabla 2 se basaban en la disminución de laproducción de leche y de la ganancia de peso en el niño de la madre fumadora y la exposición del niño alambiente de humo como demostraba la presencia de nicotina y su metabolito primario, cotinina, en laleche humana. 4-12, Existe controversia con respecto a los efectos de nicotina en el tamaño de niño al añode edad.13, 14. En el humo del tabaco hay centenares de componentes; sin embargo, nicotina y sumetabolito cotinina son los marcadores mas frecuentes usados en la exposición al tabaco. La Nicotina noes necesariamente el único componente que puede causar un aumento de enfermedades respiratorias através dela leche materna (incluyendo otitis media) además en el lactante se debe considerar también laexposición al ambiente de humos. La Nicotina esta presente en la leche en concentraciones entre 1.5 a3.0 veces la concentración simultanea del plasma materno, 15 y la eliminación intermedia es similar 60 a90 minutos en la leche y el plasma. 7. No hay evidencia para decir que esta cantidad de nicotina representeun riesgo para la salud del niño.
El Comité de Medicamentos desea apoyar el énfasis de la Academia Americana de Pediatría por elincremento de la lactancia materna en los Estados Unidos. El embarazo y la lactancia son las ocasionesideales para que los médicos recomienden el abandono del tabaco. Debemos aceptar que hay mujeresque son incapaces de abandonar el tabaco. Un estudio informó que, entre mujeres que continuaban fumando y lactando, la incidencia de enfermedades respiratorias agudas era menor que en las madresfumadoras que alimentaban a sus hijos con lactancia artificial 16 Esto puede se debe a que lactar y fumares menos dañino para el niño que el biberón más el hábito del tabaco. El Comité de Medicamentos esperaobtener más datos sobre este tema. El Comité de Medicamentos no ha colocado la nicotina (ytabaquismo) en ninguna de las Tablas pero espera que el interés por la alimentación al pecho de unamadre fumadora servirá como un punto de la discusión acerca del abandono del habito del tabaco entre elpediatra y la madre que va a lactar o que lacta al niño. Sin embargo no se han estudiado suficientementepor el Comité de Medicamentos las fuentes alternativas de nicotina(oral, transcutanea) que ayudan adejar el habito del tabaco para hacer una recomendación a favor o en contra en la mujer que lacta.
DROGAS PSICOTROPAS
Los ansiolíticos, antidepresivos, y neurolépticos se han colocado en la Tabla 4, "Medicamentos en losque el Efecto sobre el niño lactado es desconocido pero puede ser de preocupación." Estos medicamentosaparecen en concentraciones bajas (generalmente con una relación de leche a plasma de 0.5-1.0) en laleche después de la ingestión materna. Como consecuencia de la larga vida media de estos componentesy algunos de sus metabolitos, los niños lactados pueden tener cantidades medibles en su plasma y tejidos,así como en el cerebro. Esto es particularmente importante en niños lactados en los primeros meces de lavida, con inmadurez hepática y de la función renal. Las madres que lactan deben ser informadas que siellas toman uno de estos medicamentos, el niño estará expuesto a ello. A causa de que estosmedicamentos afectan la función de los neurotransmisores en el sistema nervioso en desarrollo y puedeque no sea posible predecir los efectos a plazo largo del desarrollo neurológico IMPLANTES DE SILICONA EN LA MAMA Y LACTANCIA MATERNA
Aproximadamente de 800 000 al 1 millón de mujeres en los Estados Unidos han recibido implantesmamarios que contienen silicona (silicio elemental con lazos químicos al oxígeno) en la cubierta o en elgel interior del implante. Se ha incrementado la preocupación acerca de los posibles efectos al niñolactado si la madre que lacta es portadora de implantes. Esta preocupación se origino en informes quedescribieron disfunción esofágica en 11 niños cuyas madres tenían implantes .17,18. Este hallazgo no hasido confirmado por otros informes. La química de la Silicona es extremadamente compleja; el polímeroimplicado en la cubierta y el interior del injerto de seno se compone de un polímero de silicio alternante yátomos de oxígeno con grupos de metilo conectados a los grupos del oxígeno (methylpolydimethylsiloxane). 19 La longitud del polímero determina si es un sólido, un gel o un liquido. Haysolo unos pocos ejemplos del polímero que hayan sido experimentados en la leche de mujer conimplantes; las concentraciones no son mas elevadas que las muestra de control 20 No hay evidencia en elmomento actual que este polimero sea directamente toxico en los tejidos humanos; sin embargo tambienexiste preocupación de que la toxicidad pueda ser mediada por mecanismo inmunológico. Esto no ha sidotodavía confirmado en humanos. Excepto por el estudio citado arriba, no hay mas informes de problemasclinicos en madres con implantes de silicona 21. Es improbable que el silicio cause problemas porque estapresente en la leche de vaca y de formula en una concentración más alta que en la leche procedente demadre con implantes. 22 La simeticona ( anticolico) tiene una estructura muy semejante al polidimetilsiloxane del seno. Simeticona se ha utilizado por décadas en este país y Europa sin ninguna evidencia detoxicidad en niños. El Comité de Medicamentos no cree que la evidencia disponible actualmentejustifique clasificar los implantes de silicona como una contraindicación de la lactancia materna TERAPIA CON MEDICAMENTOS SOBRE LA MUJER QUE LACTA
Antes de prescribir medicamentos a las mujeres que lactan se debería realizar esta consideración: 1. ¿Es el medicamento absolutamente necesario? Si se precisa el medicamento una consulta entre elpediatra y el medico de la madre puede ser más útil para determinar que opciones escoger . 2. Se debe escoger el medicamento más seguro, por ejemplo, acetaminofen antes que aspirina para laanalgesia.
3. Si hay una posibilidad de que un medicamento pueda presentar un riesgo para el niño, debe tomarseen consideración la medida de las concentraciones plasmáticas en el niño lactado.
4. La exposición al medicamento puede ser disminuida haciendo que la madre tome el medicamentoinmediatamente después de que ella haya amamantado o inmediatamente antes de que el lactante tenga unlargo periodo de sueño Los datos se han obtenido de una búsqueda de la literatura médica. Porque las metodologías usadas paracuantificar los medicamentos mejoran continuamente, esta información requiere actualización frecuente.
Los medicamentos citados en las tablas 1 a 7 están ordenados en orden alfabético por su nombregenérico, los nombres comerciales están disponibles citado en Tablas 1 por 7 en Physicians' DeskReference,23 USP DI 2001: Drug Information for the Health Care Professional, Volume I,24 and USPDictionary of USAN and International Drug Names. La lista de referencia no incluye todos los artículospublicados sobre el tema. Para la traducción Española se ha consultado en Martindale “ The completedrug reference “ 32 edition Pharmaceutical Press 1999 y Catalogo de Especialidades Farmacéuticas.
Consejo General de Colegios Oficiales de Farmacéuticos 2001 Los médicos que encuentren efectos adversos en niños de medicamentos-contaminantes en la lechehumana se les insta a que documenten estos efectos en una comunicación a la Food and DrugAdministration (http://www.fda.gov/medwatch/index.html) y al Comité de Medicamentos. Estacomunicación debe incluir el genérico y los nombres comerciales del medicamento, la dosis de la madrey la posología, la concentración del medicamento en la leche materna y en el plasma del niño relacionadocon el tiempo de la ingestión, el método usado para la identificación del laboratorio, la edad del niño, y delos efectos adversos. Tales informes pueden aumentar sustancialmente el conocimiento de la comunidadpediátrica con relación a la trasferencia de los medicamentos en la leche humana , y los riesgospotenciales o actuales en el lactante.
COMMITTEE ON DRUGS, 2000-2001Robert M. Ward, MD, ChairpersonBrian A. Bates, MDWilliam E. Benitz, MDDavid J. Burchfield, MDJohn C. Ring, MDRichard P. Walls, MD, PhDPhilip D. Walson, MDLIAISONSJohn Alexander, MD Food and Drug Administration AlternateDonald R. Bennett, MD, PhD American Medical Association/United States PharmacopeiaTherese Cvetkovich, MD Food and Drug AdministrationOwen R. Hagino, MD American Academy of Child and Adolescent PsychiatryStuart M. MacLeod, MD, PhD Canadian Paediatric SocietySiddika Mithani, MD Bureau of Pharmaceutical Assessment Health Protection Branch, CanadaJoseph Mulinare, MD, MSPH Centers for Disease Control and PreventionLaura E. Riley, MD American College of Obstetricians and GynecologistsSumner J. Yaffe, MD National Institutes of HealthSECTION LIAISONSCharles J. Coté, MD Section on AnesthesiologyEli O. Meltzer, MD Section on Allergy and ImmunologyCONSULTANTCheston M. Berlin, Jr, MDSTAFF ACKNOWLEDGMENT
The Committee on Drugs would like to thank Linda Watson for her work in referenceidentification, document retrieval, and manuscript preparation.
REFERENCES
1. American Academy of Pediatrics, Committee on Drugs. The transfer of drugs and other chemicals into human breast milk. Pediatrics. 1983;72:375-383 2. American Academy of Pediatrics, Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 1989;84:924-936 3. American Academy of Pediatrics, Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 1994;93:137-150 4. Bisdom W. Alcohol and nicotine poisoning in nurslings. JAMA. 1937;109:178 5. Ferguson BB, Wilson DJ, Schaffner W. Determination of nicotine concentrations in human milk. Am J Dis Child. 1976;130:837-839 6. Luck W, Nau H. Nicotine and cotinine concentrations in the milk of smoking mothers: influence of cigarette consumption and diurnal variation. Eur J Pediatr. 1987;146:21-26 7. Luck W, Nau H. Nicotine and cotinine concentrations in serum and milk of nursing mothers. Br J Clin Pharmacol. 1984;18:9-15 8. Luck W, Nau H. Nicotine and cotinine concentrations in serum and urine of infants exposed via passive smoking or milk from smoking mothers. J Pediatr. 1985;107:816-820 9. Labrecque M, Marcoux S, Weber JP, Fabia J, Ferron L. Feeding and urine cotinine values in babies whose mothers smoke. Pediatrics. 1989;83:93-97 10. Schwartz-Bickenbach D, Schulte-Hobein B, Abt S, Plum C, Nau H. Smoking and passive smoking during pregnancy and early infancy: effects on birth weight, lactationperiod, and cotinine concentrations in mother's milk and infant's urine. Toxicol Lett.
1987;35:73-81 11. Schulte-Hobein B, Schwartz-Bickenbach D, Abt S, Plum C, Nau H. Cigarette smoke exposure and development of infants throughout the first year of life: influence ofpassive smoking and nursing on cotinine levels in breast milk and infant's urine. ActaPaediatr. 1992;81:550-557 12. Hopkinson JM, Schanler RJ, Fraley JK, Garza C. Milk production by mothers of premature infants: influence of cigarette smoking. Pediatrics. 1992;90:934-938 13. Little RE, Lambert MD III, Worthington-Roberts B, Ervin CH. Maternal smoking during lactation: relation to infant size at one year of age. Am J Epidemiol.
1994;140:544-554 14. Boshuizen HC, Verkerk PH, Reerink JD, Herngreen WP, Zaadstra BM, Verloove- Vanhorick SP. Maternal smoking during lactation: relation to growth during the firstyear of life in a Dutch birth cohort. Am J Epidemiol. 1998;147:117-126 15. Steldinger R, Luck W, Nau H. Half lives of nicotine in milk of smoking mothers: implications for nursing. J Perinat Med. 1988;16:261-262 16. Woodward A, Douglas RM, Graham NM, Miles H. Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking. J EpidemiolCommunity Health. 1990;44:224-230 17. Levine JJ, Ilowite NT. Sclerodermalike esophageal disease in children breast-fed by mothers with silicone breast implants. JAMA. 1994;271:213-216 18. Levine JJ, Trachtman H, Gold DM, Pettei MJ. Esophageal dysmotility in children breast-fed by mothers with silicone breast implants: long-term follow-up and responseto treatment. Dig Dis Sci. 1996;41:1600-1603 19. LeVier RR, Harrison MC, Cook RR, Lane TH. What is silicone? Plast Reconstr Surg.
20. Berlin CM Jr. Silicone breast implants and breast-feeding. Pediatrics. 1994;94:547-549 21. Kjoller K, Mclaughlin JK, Friis S, et al. Health outcomes in offspring of mothers with breast implants. Pediatrics. 1998;102:1112-1115 22. Semple JL, Lugowski SJ, Baines CJ, Smith DC, McHugh A. Breast milk contamination and silicone implants: preliminary results using silicon as a proxy measurement forsilicone. Plast Reconstr Surg. 1998;102:528-533 23. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company; 2001 24. US Pharmacopeia. USP DI 2001: Information for the Health Care Professional, Volume I. Hutchinson TA, ed. Englewood, CO: Micromedex; 2001 25. US Pharmacopeia. USP Dictionary of USAN and International Drug Names. Rockville, 26. Wiernik PH, Duncan JH. Cyclophosphamide in human milk. Lancet. 1971;1:912 27. Amato D, Niblett JS. Neutropenia from cyclophosphamide in breast milk. Med J Aust.
28. Flechner SM, Katz AR, Rogers AJ, Van Buren C, Kahan BD. The presence of cyclosporine in body tissue and fluids during pregnancy. Am J Kidney Dis. 1985;5:60-63 29. Nyberg G, Haljamae, Frisenette-Fich C, Wennergren M, Kjellmer I. Breast-feeding during treatment with cyclosporine. Transplantation. 1998;65:253-255 30. Egan PC, Costanza ME, Dodion P, Egorin MJ, Bachur NR. Doxorubicin and cisplatin excretion into human milk. Cancer Treat Rep. 1985;69:1387-1389 31. Johns DG, Rutherford LD, Leighton PC, Vogel CL. Secretion of methotrexate into human milk. Am J Obstet Gynecol. 1972;112:978-980 32. Steiner E, Villen T, Hallberg M, Rane A. Amphetamine secretion in breast milk. Eur J 33. Chasnoff IJ, Lewis DE, Squires L. Cocaine intoxication in a breast-fed infant.
34. Cobrinik RW, Hood RT Jr, Chusid E. The effect of maternal narcotic addiction on the newborn infant: review of literature and report of 22 cases. Pediatrics. 1959;24:288-304 35. Perez-Reyes M, Wall ME. Presence of delta9-tetrahydrocannabinol in human milk. N 36. Kaufman KR, Petrucha RA, Pitts FN Jr, Weekes ME. PCP in amniotic fluid and breast milk: case report. J Clin Psychiatry. 1983;44:269-270 37. McArdle HJ, Danks DM. Secretion of copper 64 into breast milk following intravenous injection in a human subject. J Trace Elem Exp Med. 1991;4:81-84 38. Tobin RE, Schneider PB. Uptake of 67Ga in the lactating breast and its persistence in milk: case report. J Nucl Med. 1976;17:1055-1056 39. Butt D, Szaz KF. Indium-111 radioactivity in breast milk. Br J Radiol. 1986;59:80 40. Hedrick WR, Di Simone RN, Keen RL. Radiation dosimetry from breast milk excretion of radioiodine and pertechnetate. J Nucl Med. 1986;27:1569-1571 41. Rose MR, Prescott MC, Herman KJ. Excretion of iodine-123-hippuran, technetium-99 m-red blood cells, and technetium-99 m-macroaggregated albumin into breast milk. JNucl Med. 1990;31:978-984 42. Palmer KE. Excretion of 125I in breast milk following administration of labelled fibrinogen. Br J Radiol. 1979;52:672-673 43. Honour AJ, Myant NB, Rowlands EN. Secretion of radioiodine in digestive juices and milk in man. Clin Sci. 1952;11:447-462 44. Karjalainen P, Penttila IM, Pystynen P. The amount and form of radioactivity in human milk after lung scanning, renography and placental localization by 131 I labelledtracers. Acta Obstet Gynecol Scand. 1971;50:357-361 45. Bland EP, Docker MF, Crawford JS, Farr RF. Radioactive iodine uptake by thyroid of breast-fed infants after maternal blood-volume measurements. Lancet. 1969;2:1039-1041 46. Nurnberger CE, Lipscomb A. Transmission of radioiodine (I131) to infants through human maternal milk. JAMA. 1952;150:1398-1400 47. Robinson PS, Barker P, Campbell A, Henson P, Surveyor I, Young PR. Iodine-131 in breast milk following therapy for thyroid carcinoma. J Nucl Med. 1994;35:1797-1801 48. Rubow S, Klopper J, Wasserman H, Baard B, van Niekerk M. The excretion of radiopharmaceuticals in human breast milk: additional data and dosimetry. Eur J NuclMed. 1994;21:144-153 49. Pommerenke WT, Hahn PF. Secretion of radio-active sodium in human milk. Proc Soc 50. O'Connell ME, Sutton H. Excretion of radioactivity in breast milk following 99Tcm-Sn polyphosphate. Br J Radiol. 1976;49:377-379 51. Berke RA, Hoops EC, Kereiakes JC, Saenger EL. Radiation dose to breast-feeding. J 52. Vagenakis AG, Abreau CM, Braverman LE. Duration of radioactivity in the milk of a nursing mother following 99 mTc administration. J Nucl Med. 1971;12:188 53. Wyburn JR. Human breast milk excretion of radionuclides following administration of radiopharmaceuticals. J Nucl Med. 1973;14:115-117 54. Pittard WB III, Merkatz R, Fletcher BD. Radioactive excretion in human milk following administration of technetium Tc 99 m macroaggregated albumin. Pediatrics.
1982;70:231-234 55. Maisels MJ, Gilcher RO. Excretion of technetium in human milk. Pediatrics.
56. American Academy of Pediatrics, Committee on Drugs. Psychotropic drugs in pregnancy and lactation. Pediatrics. 1982;69:241-244 57. Oo CY, Kuhn RJ, Desai N, Wright CE, McNamara PJ. Pharmacokinetics in lactating women: prediction of alprazolam transfer into milk. Br J Clin Pharmacol. 1995;40:231-236 58. Patrick MJ, Tilstone WJH, Reavey P. Diazepam and breast-feeding. Lancet.
59. Cole AP, Hailey DM. Diazepam and active metabolite in breast milk and their transfer to the neonate. Arch Dis Child. 1975;50:741-742 60. Dusci LJ, Good SM, Hall RW, Ilett KF. Excretion of diazepam and its metabolites in human milk during withdrawal from combination high dose diazepam and oxazepam.
Br J Clin Pharmacol. 1990;29:123-126 61. Borgatta L, Jenny RW, Gruss L, Ong C, Barad D. Clinical significance of methohexital, meperidine, and diazepam in breast milk. J Clin Pharmacol. 1997;37:186-192 62. Dencker SJ, Johansson G, Milsom I. Quantification of naturally occurring benzodiazepine-like substances in human breast milk. Psychopharmacology ( Berl).
1992;107:69-72 63. Summerfield RJ, Nielson MS. Excretion of lorazepam into breast milk. Br J Anaesth.
64. Matheson I, Lunde PK, Bredesen JE. Midazolam and nitrazepam in the maternity ward: milk concentrations and clinical effects. Br J Clin Pharmacol. 1990;30:787-793 65. Olesen OV, Bartels U, Poulsen JH. Perphenazine in breast milk and serum. Am J 66. Brodie RR, Chasseaud LF, Taylor T. Concentrations of N- descyclopropylmethylprazepam in whole-blood, plasma, and milk after administrationof prazepam to humans. Biopharm Drug Dispos. 1981;2:59-68 67. Hilbert JM, Gural RP, Symchowicz S, Zampaglione N. Excretion of quazepam into human breast milk. J Clin Pharmacol. 1984;24:457-462 68. Lebedevs TH, Wojnar-Horton RE, Yapp P, et al. Excretion of temazepam in breast milk. Br J Clin Pharmacol. 1992;33:204-206 69. Bader TF, Newman K. Amitriptyline in human breast milk and the nursing infant's serum. Am J Psychiatry. 1980;137:855-856 70. Erickson SH, Smith GH, Heidrich F. Tricyclics and breast feeding. Am J Psychiatry.
71. Gelenberg AJ. Single case stuy. Amoxapine, a new antidepressant, appears in human milk. J Nerv Ment Dis. 1979;167:635-636 72. Briggs GG, Samson JH, Ambrose PJ, Schroeder DH. Excretion of bupropion in breast milk. Ann Pharmacother. 1993;27:431-433 73. Schimmell MS, Katz EZ, Shaag Y, Pastuszak A, Koren G. Toxic neonatal effects following maternal clomipramine therapy. Clin Toxicol. 1991;29:479-484 74. Sovner R, Orsulak PJ. Excretion of imipramine and desipramine in human breast milk.
75. Stancer HC, Reed KL. Desipramine and 2-hydroxydesipramine in human breast milk and the nursery infant's serum. Am J Psychiatry. 1986;143:1597-1600 76. Rees JA, Glass RC, Sporne GA. Serum and breast-milk concentrations of dothiepin [letter]. Practitioner. 1976;217:686 77. Ilett KF, Lebedevs TH, Wojnar-Horton RE, et al. The excretion of dothiepin and its primary metabolites in breast milk. Br J Clin Pharmacol. 1992;33:635-639 78. Kemp J, Ilett KF, Booth J, Hackett LP. Excretion of doxepin and N-desmethyldoxepin in human milk. Br J Clin Pharmacol. 1985;20:497-499 79. Burch KJ, Wells BG. Fluoxetine/norfluoxetine concentrations in human milk.
80. Lester BM, Cucca J, Andreozzi L, Flanagan P, Oh W. Possible association between fluoxetine hydrochloride and colic in an infant. J Am Acad Child Adolesc Psychiatry.
1993;32:1253-1255 81. Burch KJ, Wells BG. Fluoxetine/norfluoxetine concentrations in human milk.
82. Taddio A, Ito S, Koren G. Excretion of fluoxetine and its metabolite, norfluoxetine, in human breast milk. J Clin Pharmacol. 1996;36:42-47 83. Brent NB, Wisner KL. Fluoxetine and carbamazepine concentrations in a nursing mother/infant pair. Clin Pediatr ( Phila). 1998;37:41-44 84. Isenberg KE. Excretion of fluoxetine in human breast milk. J Clin Psychiatry.
85. Nulman I, Koren G. The safety of fluoxetine during pregnancy and lactation.
86. Yoshida K, Smith B, Craggs M, Kumar RC. Fluoxetine in breast-milk and developmental outcome of breast-fed infants. Br J Psychiatry. 1998;172:175-178 87. Chambers CD, Anderson PO, Thomas RG, et al. Weight gain in infants breastfed by mothers who take fluoxetine. Pediatrics. 1999;104(5). Available at:http://www.pediatrics.org/cgi/content/full/104/5/e61. Accessed December 20, 2000 88. Wright S, Dawling S, Ashford JJ. Excretion of fluvoxamine in breast milk. Br J Clin 89. Wisner KL, Perel JM. Serum nortriptyline levels in nursing mothers and their infants.
Am J Psychiatry. 1991;148:1234-1236 90. Wisner KL, Perel JM. Nortriptyline treatment of breast-feeding women. Am J 91. Stowe ZN, Cohen LS, Hostetter A, Ritchie JC, Owens MJ, Nemeroff CB. Paroxetine in human breast milk and nursing infants. Am J Psychiatry. 2000;157:185-189 92. Epperson CN, Anderson GM, McDougle CJ. Sertraline and breast-feeding. N Engl J 93. Stowe ZN, Owens MJ, Landry JC, et al. Sertraline and desmethylsertraline in human breast milk and nursing infants. Am J Psychiatry. 1997;154:1255-1260 94. Verbeeck RK, Ross SG, McKenna EA. Excretion of trazodone in breast milk. Br J Clin 95. Polishuk WZ, Kulcsar SA. Effects of chlorpromazine on pituitary function. J Clin 96. Wiles DH, Orr MW, Kolakowska T. Chlorpromazine levels in plasma and milk of nursing mothers. Br J Clin Pharmacol. 1978;5:272-273 97. Nielsen ST, Matheson I, Rasmussen JN, Skinnemoen K, Andrew E, Hafsahl G.
Excretion of iohexol and metrizoate in human breast milk. Acta Radiol. 1987;28:523-526 98. Ohkubo T, Shimoyama R, Sugawara K. Determination of chlorpromazine in human breast milk and serum by high-performance liquid chromatography. J Chromatogr.
1993;614:328-332 99. Matheson I, Evang A, Overo KF, Syversen G. Presence of chlorprothixene and its metabolites in breast milk. Eur J Clin Pharmacol. 1984;27:611-613 100. Barnas C, Bergant A, Hummer M, Saria A, Fleischhacker WW. Clozapine concentrations in maternal and fetal plasma, amniotic fluid, and breast milk. Am JPsychiatry. 1994;151:945 101. Stewart RB, Karas B, Springer PK. Haloperidol excretion in human milk. Am J 102. Whalley LJ, Blain PG, Prime JK. Haloperidol secreted in breast milk. Br Med J ( Clin 103. Ohkubo T, Shimoyama R, Sugawara K. Measurement of haloperidol in human breast milk by high-performance liquid chromatography. J Pharm Sci. 1992;81:947-949 104. Yoshida K, Smith B, Craggs M, Kumar RC. Neuroleptic drugs in breast milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol Med.
1998;28:81-91 105. Ananth J. Side effects in the neonate from psychotropic agents excreted through breast- feeding. Am J Psychiatry. 1978;135:801-805 106. Plomp TA, Vulsma T, de Vijlder JJ. Use of amiodarone during pregnancy. Eur J Obstet Gynecol Reprod Biol. 1992;43:201-207 107. Havelka J, Hejzlar M, Popov V, Viktorinova D, Prochazka J. Excretion of chloramphenicol in human milk. Chemotherapy. 1968;13:204-211 108. Smadel JE, Woodward TE, Ley HL Jr, et al. Chloramphenicol Chloromycetin) in the treatment of tsutsugamushi disease (scrub typhus). J Clin Invest. 1949;28:1196 109. Venkatesan K, Mathur A, Girdhar A, Girdhar BK. Excretion of clofazimine in human milk in leprosy patients. Lepr Rev. 1997;68:242-246 110. Tomson T, Ohman I, Vitols S. Lamotrigine in pregnancy and lactation: a case report.
111. Gupta AP, Gupta PK. Metoclopramide as a lactogogue. Clin Pediatr (Phila).
112. Kauppila A, Arvela P, Koivisto M, Kivinen S, Ylikorkala O, Pelkonen O.
Metoclopramide and breast feeding: transfer into milk and the newborn. Eur J ClinPharmacol. 1983;25:819-823 113. Erickson SH, Oppenheim GL, Smith GH. Metronidazole in breast milk. Obstet 114. Heisterberg L, Branebjerg PE. Blood and milk concentrations of metronidazole in mothers and infants. J Perinat Med. 1983;11:114-120 115. Evaldson GR, Lindgren S, Nord CE, Rane AT. Tinidazole milk excretion and pharmacokinetics in lactating women. Br J Clin Pharmacol. 1985;19:503-507 116. Boutroy MJ, Bianchetti G, Dubruc C, Vert P, Morselli PL. To nurse when receiving acebutolol: is it dangerous for the neonate? Eur J Clin Pharmacol. 1986;30:737-739 117. Nelis GF. Diarrhoea due to 5-aminosalicylic acid in breast milk. Lancet. 1989;1:383 118. Jenss H, Weber P, Hartmann F. 5-Aminosalicylic acid its metabolite in breast milk during lactation [letter]. Am J Gastroenterol. 1990;85:331 119. Klotz U, Harings-Kaim A. Negligible excretion of 5-aminosalicylic acid in breast milk.
120. Liedholm H, Melander A, Bitzen PO, et al. Accumulation of atenolol and metoprolol in human breast milk. Eur J Clin Pharmacol. 1981;20:229-231 121. Schimmel MS, Eidelman AI, Wilschanski MA, Shaw D Jr, Ogilvie RJ, Koren G. Toxic effects of atenolol consumed during breast feeding. J Pediatr. 1989;114:476-478 122. Thorley KJ, McAinsh J. Levels of the beta-blockers atenolol and propanolol in the breast milk of women treated for hypertension in pregnancy. Biopharm Drug Dispos.
1983;4:299-301 123. Kulas J, Lunell NO, Rosing U, Steen B, Rane A. Atenolol and metoprolol. A comparison of their excretion into human breast milk. Acta Obstet Gynecol ScandSuppl. 1984;118:65-69 124. White WB, Andreoli JW, Wong SH, Cohn RD. Atenolol in human plasma and breast milk. Obstet Gynecol. 1984;63:42S-44S 125. Kulski JK, Hartmann PE, Martin JD, Smith M. Effects of bromocriptine mesylate on the composition of the mammary secretion in non-breast-feeding women. ObstetGynecol. 1978;52:38-42 126. Katz M, Kroll D, Pak I, Osimoni A, Hirsch M. Puerperal hypertension, stroke, and seizures after suppression of lactation with bromocriptine. Obstet Gynecol.
1985;66:822-824 127. Clark JH, Wilson WG. A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Clin Pediatr ( Phila). 1981;20:53-54 128. Levy G. Salicylate pharmacokinetics in the human neonate. In: Marselli PL, ed. Basic and Therapeutic Aspects of Perinatal Pharmacology. New York, NY: Raven Press;1975:319 129. Jamali F, Keshavarz E. Salicylate excretion in breast milk. Int J Pharm. 1981;8:285- 130. Kok TH, Taitz LS, Bennett MJ, Holt DW. Drowsiness due to clemastine transmitted in breast milk. Lancet. 1982;1:914-915 131. Fomina PI. Untersuchungen uber den Ubergang des aktiven agens des Mutterkorns in die milch stillender Mutter. Arch Gynecol. 1934;157:275 132. Schou M, Amdisen A. Lithium and pregnancy. 3. Lithium ingestion by children breast- fed by women on lithium treatment. Br Med J. 1973;2:138 133. Tunnessen WW Jr, Hertz CG. Toxic effects of lithium in newborn infants: a commentary. J Pediatr. 1972;81:804-807 134. Sykes PA, Quarrie J, Alexander FW. Lithium carbonate and breast-feeding. Br Med J.
135. Eckstein HB, Jack B. Breast-feeding and anticoagulant therapy. Lancet. 1970;1:672- 136. Nau H, Rating D, Hauser I, Jager E, Koch S, Helge H. Placental transfer and pharmacokinetics of primidone and its metabolites phenobarbital, PEMA andhydroxyphenobarbital in neonates and infants of epileptic mothers. Eur J ClinPharmacol. 1980;18:31-42 137. Kuhnz W, Koch S, Helge H, Nau H. Primidone and phenobarbital during lactation period in epileptic women: total and free drug serum levels in the nursed infants andtheir effects on neonatal behavior. Dev Pharmacol Ther. 1988;11:147-154 138. Finch E, Lorber J. Methaemoglobinaemia in newborn probably due to phenytoin excreted in human milk. J Obstet Gynaecol Br Emp. 1954;61:833-834 139. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. II.
Barbiturates. J Pediatr. 1938;13:86-90 140. Knott C, Reynolds F, Clayden G. Infantile spasms on weaning from breast milk containing anticonvulsants. Lancet. 1987;2:272-273 141. Branski D, Kerem E, Gross-Kieselstein E, Hurvitz H, Litt R, Abrahamov A. Bloody diarrhea-a possible complication of sulfasalazine transferred through human breastmilk. J Pediatr Gastroenterol Nutr. 1986;5:316-317 142. Berlin CM Jr, Yaffe SJ, Ragni M. Disposition of acetaminophen in milk, saliva, and plasma of lactating women. Pediatr Pharmacol (New York). 1980;1:135-141 143. Bitzen PO, Gustafsson B, Jostell KG, Melander A, Wahlin-Boll E. Excretion of paracetamol in human breast milk. Eur J Clin Pharmacol. 1981;20:123-125 144. Findlay JW, DeAngelis RL, Kearney MF, Welch RM, Findlay JM. Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther. 1981;29:625-633 145. Soderman P, Hartvig P, Fagerlund C. Acetazolamide excretion into human breast milk.
Br J Clin Pharmacol. 1984;17:599-600 146. Rollman O, Pihl-Lundin I. Acitretin excretion into human breast milk. Acta Derm 147. Lau RJ, Emery MG, Galinsky RE. Unexpected accumulation of acyclovir in breast milk with estimation of infant exposure. Obstet Gynecol. 1987;69:468-471 148. Meyer LJ, de Miranda P, Sheth N, Spruance S. Acyclovir in human breast milk. Am J 149. Binkiewicz A, Robinson MJ, Senior B. Pseudo-Cushing syndrome caused by alcohol in breast milk. J Pediatr. 1978;93:965-967 150. Cobo E. Effect of different doses of ethanol on the milk-ejecting reflex in lactating women. Am J Obstet Gynecol. 1973;115:817-821 151. Kesaniemi YA. Ethanol and acetaldehyde in the milk and peripheral blood of lactating women after ethanol administration. J Obstet Gynaecol Br Commonw. 1974;81:84-86 152. Little RE, Anderson KW, Ervin CH, Worthington-Roberts B, Clarren SK. Maternal alcohol use during breast-feeding and infant mental and motor development at one year.
N Engl J Med. 1989;321:425-430 153. Kamilli I, Gresser U. Allopurinol and oxypurinol in human breast milk. Clin Investig.
154. Kafetzis DA, Siafas CA, Georgakopoulos PA, Papadatos CJ. Passage of cephalosporins and amoxicillin into the breast milk. Acta Paediatr Scand. 1981;70:285-288 155. Berman JD, Melby PC, Neva FA. Concentration of Pentostam in human breast milk.
Trans R Soc Trop Med Hyg. 1989;83:784-785 156. Sapeika N. Excretion of drugs in human milk: review. J Obstet Gynaecol Br Emp.
157. Bald R, Bernbeck-Betthauser EM, Spahn H, Mutschler E. Excretion of azpropazone in human breast milk. Eur J Clin Pharmacol. 1990;39:271-273 158. Fleiss PM, Richwald GA, Gordon J, Stern M, Frantz M, Devlin RG. Aztreonam in human serum and breast milk. Br J Clin Pharmacol. 1985;19:509-511 159. Nail PA, Thomas MR, Eakin R. The effect of thiamin and riboflavin supplementation on the level of those vitamins in human breast milk and urine. Am J Clin Nutr.
1980;33:198-204 160. Roepke JL, Kirksey A. Vitamin B6 nutriture during pregnancy lactation. I. Vitamin B6 intake, levels of the vitamin in biological fluids, condition of the infant at birth. Am JClin Nutr. 1979;32:2249-2256 161. West KD, Kirksey A. Influence of vitamin B6 intake on the content of the vitamin in human milk. Am J Clin Nutr. 1976;29:961-969 162. Greentree LB. Dangers of vitamin B6 in nursing mothers. N Engl J Med. 1979;300:141- 163. Samson RR, McClelland DB. Vitamin B12 in human colostrum and milk. Quantitation of the vitamin and its binder and the uptake of bound vitamin B12 by intestinal bacteria.
Acta Paediatr Scand. 1980;69:93-99 164. Eriksson G, Swahn CG. Concentrations of baclofen in serum and breast milk from a lactating woman. Scand J Clin Lab Invest. 1981;41:185-187 165. Healy M. Suppressing lactaton with oral diuretics. Lancet. 1961;1:1353 166. Brambel CE, Hunter RE. Effect of dicumarol on the nursing infant. Am J Obstet 167. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. III.
Bromides. J Pediatr. 1938;13:91-93 168. Pittman KA, Smyth RD, Losada M, Zighelboim I, Maduska AL, Sunshine A. Human perinatal distribution of butorphanol. Am J Obstet Gynecol. 1980;138:797-800 169. Berlin CM Jr. Excretion of the methylxanthines in human milk. Semin Perinatol.
170. Tyrala EE, Dodson WE. Caffeine secretion into breast milk. Arch Dis Child.
171. Hildebrandt R, Gundert-Remy U. Lack of pharmacological active saliva levels of caffeine in breast-fed infants. Pediatr Pharmacol (New York). 1983;3:237-244 172. Berlin CM Jr, Denson HM, Daniel CH, Ward RM. Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. Pediatrics. 1984;73:59-63 173. Ryu JE. Caffeine in human milk and in serum of breast-fed infants. Dev Pharmacol 174. Ryu JE. Effect of maternal caffeine consumption on heart rate and sleep time of breast- fed infants. Dev Pharmacol Ther. 1985;8:355-363 175. Devlin RG, Fleiss PM. Captopril in human blood and breast milk. J Clin Pharmacol.
176. Nau H, Kuhnz W, Egger JH, Rating D, Helge H. Anticonvulsants during pregnancy and lactation. Transplacental, maternal and neonatal pharmacokinetics. Clin Pharmacokinet.
1982;7:508-543 177. Pynnonen S, Kanto J, Sillanpaa M, Erkkola R. Carbamazepine: placental transport, tissue concentrations in foetus and newborn, and level in milk. Acta Pharmacol Toxicol(Copenh). 1977;41:244-253 178. Silcox J, Schulz P, Horbay GL, Wassenaar W. Transfer of carbetocin into human breast milk. Obstet Gynecol. 1993;82:456-459 179. Cooper DS. Antithyroid drugs: to breast-feed or not to breast-feed. Am J Obstet 180. Lamberg BA, Ikonen E, Osterlund K, et al. Antithyroid treatment of maternal hyperthyroidism during lactation. Clin Endocrinol ( Oxf). 1984;21:81-87 181. Tyson RM, Shrader EA, Perlman HH. Drugs transmitted through breast milk. I.
Laxatives. J Pediatr. 1937;11:824-832 182. Yoshioka H, Cho K, Takimoto M, Maruyama S, Shimizu T. Transfer of cefazolin into human milk. J Pediatr. 1979;94:151-152 183. Dresse A, Lambotte R, Dubois M, Delapierre D, Kramp R. Transmammary passage of cefoxitin: additional results. J Clin Pharmacol. 1983;23:438-440 184. Shyu WC, Shah VR, Campbell DA, et al. Excretion of cefprozil into human breast milk. Antimicrob Agents Chemother. 1992;36:938-941 185. Blanco JD, Jorgensen JH, Castaneda YS, Crawford SA. Ceftazidime levels in human breast milk. Antimicrob Agents Chemother. 1983;23:479-480 186. Bourget P, Quinquis-Desmaris V, Fernandez H. Ceftriaxone distribution and protein binding between maternal blood and milk postpartum. Ann Pharmacother.
1993;27:294-297 187. Lacey JH. Dichloralphenazone and breast milk. Br Med J. 1971;4:684 188. Reed CB. A study of the conditions that require the removal of the child from the breast. Surg Gynecol Obstet. 1908;6:514 189. Soares R, Paulini E, Pereira JP. Da concentracao e eliminacao da cloroquina atraves da circulacao placentaria e do leite materno, de pacientes sob regime do sal loroquinado.
Rev Bras Malariol Doencas Trop. 1957;9:19 190. Ogunbona FA, Onyeji CO, Bolaji OO, Torimiro SE. Excretion of chloroquine and desethylchloroquine in human milk. Br J Clin Pharmacol. 1987;23:473-476 191. Edstein MD, Veenendaal JR, Newman K, Hyslop R. Excretion of chloroquine, dapsone and pyrimethamine in human milk. Br J Clin Pharmacol. 1986;22:733-735 192. Werthmann MW Jr, Krees SV. Excretion of chlorothiazide in human breast milk. J 193. Miller EM, Cohn RD, Burghart PH. Hydrochlorothiazide disposition in a mother and her breast-fed infant. J Pediatr. 1982;101:789-791 194. Mulley BA, Parr GD, Pau WK, Rye RM, Mould JJ, Siddle NC. Placental transfer of chlorthalidone and its elimination in maternal milk. Eur J Clin Pharmacol.
1978;13:129-131 195. Somogyi A, Gugler R. Cimetidine excretion into breast milk. Br J Clin Pharmacol.
196. Oo CY, Kuhn RJ, Desai N, McNamara PJ. Active transport of cimetidine into human milk. Clin Pharmacol Ther. 1995;58:548-555 197. Gardner DK, Gabbe SG, Harter C. Simultaneous concentrations of ciprofloxacin in breast milk and in serum in mother and breast-fed infant. Clin Pharm. 1992;11:352-354 198. Giamarellou H, Kolokythas E, Petrikkos G, Gazis J, Aravantinos D, Sfikakis P.
Pharmacokinetics of three newer quinolones in pregnant and lactating women. Am JMed. 1989;87(suppl):49S-51S 199. Hofmeyr GJ, Sonnendecker EW. Secretion of the gastrokinetic agent cisapride in human milk. Eur J Clin Pharmacol. 1986;30:735-736 200. Smith JA, Morgan JR, Rachlis AR, Papsin FR. Clindamycin in human breast milk [letter]. Can Med Assoc J. 1975;112:806 201. Zacharias S, Aguilera E, Assenzo JR, Zanartu J. Effects of hormonal and nonhormonal contraceptives on lactation and incidence of pregnancy. Contraception. 1986;33:203-213 202. Meny RG, Naumburg EG, Alger LS, Brill-Miller JL, Brown S. Codeine and the breastfed neonate. J Hum Lact. 1993;9:237-240 203. Milunsky JM. Breast-feeding during colchicine therapy for familial Mediterranean fever [letter]. J Pediatr. 1991;119:164 204. Ben-Chetrit E, Scherrmann J-M, Levy M. Colchicine in breast milk of patients with familial Mediterranean fever. Arthritis Rheum. 1996;39:1213-1217 205. Guillonneau M, Aigrain EJ, Galliot M, Binet MH, Darbois Y. Colchicine is excreted at high concentrations in human breast milk. Eur J Obstet Gynecol Reprod Biol.
1995;61:177-178 206. Nilsson S, Mellbin T, Hofvander Y, Sundelin C, Valentin J, Nygren KG. Long-term follow-up of children breast-fed by mothers using oral contraceptives. Contraception.
1986;34:443-457 207. Nilsson S, Nygren KG. Transfer of contraceptive steroids to human milk. Res Reprod.
208. American Academy of Pediatrics, Committee on Drugs. Breast-feeding and contraception. Pediatrics. 1981;68:138-140 209. Barsivala VM, Virkar KD. The effect of oral contraceptives on concentration of various components of human milk. Contraception. 1973;7:307-312 210. Borglin NE, Sandholm LE. Effect of oral contraceptives on lactation. Fertil Steril.
211. Curtis EM. Oral-contraceptive feminization of a normal male infant: report of a case.
212. Kora SJ. Effect of oral contraceptives on lactation. Fertil Steril. 1969;20:419-423 213. Toaff R, Ashkenazi H, Schwartz A, Herzberg M. Effects of oestrogen and progestagen on the composition of human milk. J Reprod Fertil. 1969;19:475-482 214. Snider DE Jr, Powell KE. Should women taking antituberculosis drugs breast-feed? 215. Cancela L, Le Boulch N, Miravet L. Relationship between the vitamin D content of maternal milk and the vitamin D status of nursing women and breast-fed infants. JEndocrinol. 1986;110:43-50 216. Rothberg AD, Pettifor JM, Cohen DF, Sonnendecker EW, Ross FP. Maternal-infant vitamin D relationships during breast-feeding. J Pediatr. 1982;101:500-503 217. Greer FR, Hollis BW, Napoli JL. High concentrations of vitamin D2 in human milk associated with pharmacologic doses of vitamin D2. J Pediatr. 1984;105:61-64 218. Greenhalf JO, Leonard HS. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner. 1973;210:259-263 219. Dreisbach JA. Sulphone levels in breast milk of mothers on sulphone therapy. Lepr 220. Mortimer EA Jr. Drug toxicity from breast milk [letter]? Pediatrics. 1977;60:780-781 221. FitzJohn TP, Williams DG, Laker MF, Owen JP. Intravenous urography during lactation. Br J Radiol. 1982;55:603-605 222. Loughnan PM. Digoxin excretion in human breast milk. J Pediatr. 1978;92:1019-1020 223. Levy M, Granit L, Laufer N. Excretion of drugs in human milk. N Engl J Med.
224. Okada M, Inoue H, Nakamura Y, Kishimoto M, Suzuki T. Excretion of diltiazem in human milk [letter]. N Engl J Med. 1985;312:992-993 225. Zylber-Katz E, Linder N, Granit L, Levy M. Excretion of dipyrone metabolites in human breast milk. Eur J Clin Pharmacol. 1986;30:359-361 226. MacKintosh D, Buchanan N. Excretion of disopyramide in human breast milk [letter].
Br J Clin Pharmacol. 1985;19:856-857 227. Hoppu K, Neuvonen PJ, Korte T. Disopyramide and breast feeding [letter]. Br J Clin 228. Hofmeyr GJ, van Idlekinge B. Domperidone and lactation [letter]. Lancet. 1983;1:647 229. Jorboe CH, Cook LN, Malesic I, Fleischaker J. Dyphylline elimination kinetics in lactating women: blood to milk transfer. J Clin Pharmacol. 1981;21:405-410 230. Redman CW, Kelly JG, Cooper WD. The excretion of enalapril and enalaprilat in human breast milk. Eur J Clin Pharmacol. 1990;38:99 231. Matsuda S. Transfer of antibiotics into maternal milk. Biol Res Pregnancy Perinatol.
232. Nilsson S, Nygren KG, Johansson ED. Transfer of estradiol to human milk. Am J 233. Koup JR, Rose JQ, Cohen ME. Ethosuximide pharmacokinetics in a pregnant patient and her newborn. Epilepsia. 1978;19:535-539 234. Steer PL, Biddle CJ, Marley WS, Lantz RK, Sulik PL. Concentration of fentanyl in colostrum after an analgesic dose. Can J Anaesth. 1992;39:231-235 235. Lucas BD Jr, Purdy CY, Scarim SK, Benjamin S, Abel SR, Hilleman DE. Terfenadine pharmacokinetics in breast milk in lactating women. Clin Pharmacol Ther.
1995;57:398-402 236. McQuinn RL, Pisani A, Wafa S, et al. Flecainide excretion in human breast milk. Clin 237. Wagner X, Jouglard J, Moulin M, Miller AM, Petitjean J, Pisapia A. Coadministration of flecainide acetate and sotalol during pregnancy: lack of teratogenic effects, passageacross the placenta, and excretion in human breast milk. Am Heart J. 1990;119:700-702 238. Dan M, Weidekamm E, Sagiv R, Portmann R, Zakut H. Penetration of fleroxacin into breast milk and pharmacokinetics in lactating women. Antimicrob Agents Chemother.
1993;37:293-296 239. Force RW. Fluconazole concentrations in breast milk. Pediatr Infect Dis J.
240. Buchanan RA, Eaton CJ, Koeff ST, Kinkel AW. The breast milk excretion of flufenamic acid. Curr Ther Res Clin Exp. 1969;11:533-538 241. Mattern J, Mayer PR. Excretion of fluorescein into breast milk. Am J Ophthalmol.
242. Retief FP, Heyns AD, Oosthuizen M, Oelofse R, van Reenen OR. Aspects of folate metabolism in lactating women studied after ingestion of 14C-methylfolate. Am J MedSci. 1979;277:281-288 243. Rofsky NM, Weinreb JC, Litt AW. Quantitative analysis of gadopentetate dimeglumine excreted in breast milk. J Magn Reson Imaging. 1993;3:131-132 244. Celiloglu M, Celiker S, Guven H, Tuncok Y, Demir N, Erten O. Gentamicin excretion and uptake from breast milk by nursing infants. Obstet Gynecol. 1994;84:263-265 245. Bell RA, Dale IM. Gold secretion in maternal milk [letter]. Arthritis Rheum.
246. Blau SP. Letter: metabolism of gold during lactation. Arthritis Rheum. 1973;16:777-778 247. Gottlieb NL. Suggested errata. Arthritis Rheum. 1974;17:1057 248. Ostensen M, Skavdal K, Myklebust G, Tomassen Y, Aarbakke J. Excretion of gold into human breast milk. Eur J Clin Pharmacol. 1986;31:251-252 249. Bennett PN, Humphries SJ, Osborne JP, Clarke AK, Taylor A. Use of sodium aurothiomalate during lactation. Br J Clin Pharmacol. 1990;29:777-779 250. Cote CJ, Kenepp NB, Reed SB, Strobel GE. Trace concentrations of halothane in human breast milk. Br J Anaesth. 1976;48:541-543 251. Liedholm H, Wahlin-Boll E, Hanson A, Ingemarsson I, Melander A. Transplacental passage and breast milk concentrations of hydralazine. Eur J Clin Pharmacol.
1982;21:417-419 252. Ostensen M, Brown ND, Chiang PK, Aarbakke J. Hydroxychloroquine in human breast milk. Eur J Clin Pharmacol. 1985;28:357 253. Nation RL, Hackett LP, Dusci LJ, Ilett KF. Excretion of hydroxychloroquine in human milk. Br J Clin Pharmacol. 1984;17:368-369 254. Townsend RJ, Benedetti T, Erickson SH, Gillespie WR, Albert KS. A study to evaluate the passage of ibuprofen into breast-milk. Drug Intell Clin Pharm. 1982;16:482-483 255. Townsend RJ, Benedetti TJ, Erickson SH, et al. Excretion of ibuprofen into breast milk.
Am J Obstet Gynecol. 1984;149:184-186 256. Eeg-Olofsson O, Malmros I, Elwin CE, Steen B. Convulsions in a breast-fed infant after maternal indomethacin [letter]. Lancet. 1978;2:215 257. Fairhead FW. Convulsions in a breast-fed infant after maternal indomethacin [letter].
258. Lebedevs TH, Wojnar-Horton RE, Yapp P, et al. Excretion of indomethacin in breast milk. Br J Clin Pharmacol. 1991;32:751-754 259. Postellon DC, Aronow R. Iodine in mother's milk [letter]. JAMA. 1982;247:463 260. Holmdahl KH. Cholecystography during lactation. Acta Radiol. 1955;45:305-307 261. Berlin CM, Lee C. Isoniazid and acetylisoniazid disposition in human milk, saliva and plasma [abstr]. Fed Proc. 1979;38:426 262. Kumar AR, Hale TW, Mock RE. Transfer of interferon alfa into human breast milk. J 263. Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breast milk. Eur 264. Ogbuokiri JE, Ozumba BC, Okonkwo PO. Ivermectin levels in human breast milk. Eur 265. Dyggve HV, Dam H, Sondergaard E. Influence on the prothrombin time of breast-fed newborn babies of one single dose of vitamin K1 or synkavit given to the mother within2 hours after birth. Acta Obstet Gynecol Scand. 1956;35:440-444 266. Von Kries R, Shearer M, McCarthy PT, Haug M, Harzer G, Goebel U. Vitamin K-1 content of maternal milk: Influence of the stage of lactation, lipid composition, andvitamin K-1 supplements given to the mother. Pediatr Res. 1987;22:513-517 267. Moretti ME, Ito S, Koren G. Disposition of maternal ketoconazole in breast milk. Am J Obstet Gynecol. 1995;173:1625-1626 268. Wischnik A, Manth SM, Lloyd J, Bullingham R, Thompson JS. The excretion of ketorolac tromethamine into breast milk after multiple oral dosing. Eur J ClinPharmacol. 1989;36:521-524 269. Lunell HO, Kulas J, Rane A. Transfer of labetalol into amniotic fluid and breast milk in lactating women. Eur J Clin Pharmacol. 1985;28:597-599 270. Atkinson H, Begg EJ. Concentration of beta-blocking drugs in human milk [letter]. J 271. Diaz S, Herreros C, Juez G, et al. Fertility regulation in nursing women: VII. Influence of Norplant levonorgestrel implants upon lactation and infant growth. Contraception.
1985;32:53-74 272. Shaaban MM, Odlind V, Salem HT, et al. Levonorgestrel concentrations in maternal and infant serum during use of subdermal levonorgestrel contraceptive implants,Norplant by nursing mothers. Contraception. 1986;33:357-363 273. Shikary ZK, Betrabet SS, Patel ZM, et al. ICMR task force study on hormonal contraception. Transfer of levonorgestrel (LNG) administered through different drugdelivery systems from the maternal circulation into the newborn infant's circulation viabreast milk. Contraception . 1987;35:477-486 274. McCann MF, Moggia AV, Higgins JE, Potts M, Becker C. The effects of a progestin- only oral contraceptive (levonorgestrel 0.03 mg) on breast-feeding. Contraception.
1989;40:635-648 275. Mizuta H, Amino N, Ichihara K, et al. Thyroid hormones in human milk and their influence on thyroid function of breast-fed babies. Pediatr Res. 1983;17:468-471 276. Zeisler JA, Gaarder TD, De Mesquita SA. Lidocaine excretion in breast milk. Drug Intell Clin Pharm. 1986;20:691-693 277. Nikodem VC, Hofmeyr GJ. Secretion of the antidiarrhoeal agent operamide oxide in breast milk. Eur J Clin Pharmacol. 1992;42:695-696 278. Hilbert J, Radwanski E, Affrime MB, Perentesis G, Symchowicz S, Zampaglione N.
Excretion of loratadine in human breast milk. J Clin Pharmacol. 1988;28:234-239 279. Cruikshank DP, Varner MW, Pitkin RM. Breast milk magnesium and calcium concentrations following magnesium sulfate treatment. Am J Obstet Gynecol.
1982;143:685 280. Hannon PR, Duggan AK, Serwint JR, Vogelhut JW, Witter F, DeAngelis C. The influence of medroxyprogesterone on the duration of breast-feeding in mothers in anurban community. Arch Pediatr Adolesc Med. 1997;151:490-496 281. Buchanan RA, Eaton CJ, Koeff ST, Kinkel AW. The breast milk excretion of mefenamic acid. Curr Ther Res Clin Exp. 1968;10:592-597 282. Wittels B, Scott DT, Sinatra RS. Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. Anesthesiology. 1990;73:864-869 283. Blinick G, Inturrisi CE, Jerez E, Wallach RC. Methadone assays in pregnant women and progeny. Am J Obstet Gynecol. 1975;121:617-621 284. Blinick G, Wallach RC, Jerez E, Ackerman BD. Drug addiction in pregnancy and the neonate. Am J Obstet Gynecol. 1976;125:135-142 285. Wojnar-Horton RE, Kristensen JH, Yapp P, Ilett KF, Dusci LJ, Hackett LP. Methadone distribution and excretion into breast milk of clients in a methadone maintenanceprogramme. Br J Clin Pharmacol. 1997;44:543-547 286. Geraghty B, Graham EA, Logan B, Weiss EL. Methadone levels in breast milk. J Hum 287. McCarthy JJ, Posey BL. Methadone levels in human milk. J Hum Lact. 2000;16:115- 288. Cooper DS, Bode HH, Nath B, Saxe V, Maloof F, Ridgway EC. Methimazole pharmacology in man: studies using or newly developed radioimmunoassay formethimazole. J Clin Endocrinol Metab. 1984;58:473-479 289. Azizi F. Effect of methimazole treatment of maternal thyrotoxicosis on thyroid function in breast-feeding infants. J Pediatr. 1996;128:855-858 290. White WB, Andreoli JW, Cohn RD. Alpha-methyldopa disposition in mothers with hypertension and in their breast-fed infants. Clin Pharmacol Ther. 1985;37:387-390 291. Shore MF. Drugs can be dangerous during pregnancy and lactations. Can Pharm J.
292. Ilett KF, Hackett LP, Paterson JW, McCormick CC. Excretion of metrizamide in milk.
293. Lownes HE, Ives TJ. Mexiletine use in pregnancy and lactation. Am J Obstet Gynecol.
294. Lewis AM, Patel L, Johnston A, Turner P. Mexiletine in human blood and breast milk.
295. Valdivieso A, Valdes G, Spiro TE, Westerman RL. Minoxidil in breast milk [letter].
296. Terwilliger WG, Hatcher RA. The elimination of morphine and quinine in human milk.
Surg Gynecol Obstet. 1934;58:823-826 297. Robieux I, Koren G, Vandenbergh H, Schneiderman J. Morphine excretion in breast milk and resultant exposure of a nursing infant. J Toxicol Clin Toxicol. 1990;28:365-370 298. Oberlander TF, Robeson P, Ward V, et al. Prenatal and breast milk morphine exposure following maternal intrathecal morphine treatment. J Hum Lact. 2000;16:137-142 299. Miller RD, Keegan KA, Thrupp LD, Brann J. Human breast milk concentration of moxalactam. Am J Obstet Gynecol. 1984;148:348-349 300. Devlin RG, Duchin KL, Fleiss PM. Nadolol in human serum and breast milk. Br J Clin 301. Belton EM, Jones RV. Haemolytic anaemia due to nalidixic acid. Lancet. 1965;2:691 302. Jamali F, Stevens DR. Naproxen excretion in milk and its uptake by the infant. Drug Intell Clin Pharm. 1983;17:910-911 303. Liu DT, Savage JM, Donnell D. Nefopam excretion in human milk. Br J Clin 304. Ehrenkranz RA, Ackerman BA, Hulse JD. Nifedipine transfer into human milk. J 305. Varsano I, Fischl J, Shochet SB. The excretion of orally ingested nitrofurantoin in human milk. J Pediatr. 1973;82:886-887 306. Laumas KR, Malkani PK, Bhatnagar S, Laumas V. Radioactivity in the breast milk of lactating women after oral administration of 3H-norethynodrel. Am J Obstet Gynecol.
1967;98:411-413 307. Pincus G, Bialy G, Layne DS, Paniagua M, Williams KI. Radioactivity in the milk of subjects receiving radioactive 19-norsteroids. Nature. 1966;212:924-925 308. Olsson B, Bolme P, Dahlstrom B, Marcus C. Excretion of noscapine in human breast milk. Eur J Clin Pharmacol. 1986;30:213-215 309. Sioufi A, Hillion D, Lumbroso P, et al. Oxprenolol placental transfer, plasma concentrations in newborns and passage into breast milk. Br J Clin Pharmacol.
1984;18:453-456 310. Fidler J, Smith V, De Swiet M. Excretion of oxprenolol and timolol in breast milk. Br J 311. Leuxner E, Pulver R. Verabreichung von irgapyrin bei schwangeren und wochnerinnen.
MMW Munch Med Wochenschr. 1956;98:84-86 312. Mirkin B. Diphenylhydantoin: placental transport, fetal localization, neonatal metabolism, and possible teratogenic effects. J Pediatr. 1971;78:329-337 313. Ostensen M. Piroxicam in human breast milk. Eur J Clin Pharmacol. 1983;25:829-830 314. McKenzie SA, Selley JA, Agnew JE. Secretion of prednisolone into breast milk. Arch 315. Greenberger PA, Odeh YK, Frederiksen MC, Atkinson AJ Jr. Pharmacokinetics of prednisolone transfer to breast milk. Clin Pharmacol Ther. 1993;53:324-328 316. Katz FH, Duncan BR. Entry of prednisone into human milk. N Engl J Med.
317. Pittard WB III, Glazier H. Procainamide excretion in human milk. J Pediatr.
318. Diaz S, Jackanicz TM, Herreros C, et al. Fertility regulation in nursing women: VIII.
Progesterone plasma levels and contraceptive efficacy of a progesterone-releasingvaginal ring. Contraception. 1985;32:603-622 319. Kunka RL, Venkataramanan R, Stern RM, Ladik CF. Excretion of propoxyphene and norpropoxyphene in breast milk. Clin Pharmacol Ther. 1984;35:675-680 320. Levitan AA, Manion JC. Propranolol therapy during pregnancy and lactation. Am J 321. Karlberg B, Lundberg D, Aberg H. Letter: excretion of propranolol in human breast milk. Acta Pharmacol Toxicol ( Copenh). 1974;34:222-224 322. Bauer JH, Pape B, Zajicek J, Groshong T. Propranolol in human plasma and breast milk. Am J Cardiol. 1979;43:860-862 323. Kampmann JP, Johansen K, Hansen JM, Helweg J. Propylthiouracil in human milk: revision of a dogma. Lancet. 1980;1:736-737 324. Findlay JW, Butz RF, Sailstad JM, Warren JT, Welch RM. Pseudoephedrine and triprolidine in plasma and breast milk of nursing mothers. Br J Clin Pharmacol.
1984;18:901-906 325. Hardell LI, Lindstrom B, Lonnerholm G, Osterman PO. Pyridostigmine in human breast milk. Br J Clin Pharmacol. 1982;14:565-567 326. Clyde DF, Shute GT, Press J. Transfer of pyrimethamine in human milk. J Trop Med 327. Hill LM, Malkasian GD Jr. The use of quinidine sulfate throughout pregnancy. Obstet 328. Horning MG, Stillwell WG, Nowlin J, Lertratanangkoon K, Stillwell RN, Hill RM.
Identification and quantification of drugs and drug metabolites in human breast milkusing gas chromatography mass spectrometry computer methods. Mod Probl Paediatr.
1975;15:73-79 329. Werthmann MW JR, Krees SV. Quantitative excretion of Senokot in human breast milk. Med Ann Dist Columbia. 1973;42:4-5 330. Hackett LP, Wojnar-Horton RE, Dusci LJ, Ilett KF, Roberts MJ. Excretion of sotalol in breast milk. Br J Clin Pharmacol. 1990;29:277-278 331. Phelps DL, Karim Z. Spironolactone: relationship between concentrations of dethioacetylated metabolite in human serum milk. J Pharm Sci. 1977;66:1203 332. Foulds G, Miller RD, Knirsch AK, Thrupp LD. Sulbactam kinetics and excretion into breast milk in postpartum women. Clin Pharmacol Ther. 1985;38:692-696 333. Jarnerot G, Into-Malmberg MB. Sulphasalazine treatment during breast feeding. Scand 334. Berlin CM Jr, Yaffe SJ. Disposition of salicylazosulfapyridine (Azulfidine) and metabolites in human breast milk. Dev Pharmacol Ther. 1980;1:31-39 335. Kauffman RE, O'Brien C, Gilford P. Sulfisoxazole secretion into human milk. J 336. Wojnar-Horton RE, Hackett LP, Yapp P, Dusci LJ, Paech M, Ilett KF. Distribution and excretion of sumatriptan in human milk. Br J Clin Pharmacol. 1996;41:217-221 337. Chaiken P, Chasin M, Kennedy B, Silverman BK. Suprofen concentrations in human breast milk. J Clin Pharmacol. 1983;23:385-390 338. Lindberberg C, Boreus LO, de Chateau P, Lindstrom B, Lonnerholm G, Nyberg L.
Transfer of terbutaline into breast milk. Eur J Respir Dis Suppl. 1984;134:87-91 339. Tetracycline in breast milk. Br Med J. 1969;4:791 340. Posner AC, Prigot A, Konicoff NG. Further observations on the use of tetracycline hydrochloride in prophylaxis and treatment of obstetric infections. In: Welch H, Marti-Ibanez F, eds. Antibiotics Annual 1954-1955. New York, NY: Medical EncyclopediaInc; 1955:594 341. Yurchak AM, Jusko WJ. Theophylline secretion into breast milk. Pediatrics.
342. Andersen LW, Qvist T, Hertz J, Mogensen F. Concentrations of thiopentone in mature breast milk and colostrum following an induction dose. Acta Anaesthesiol Scand.
1987;31:30-32 343. Williams RH, Kay GA, Jandorf BJ. Thiouracil: its absorption, distribution, and excretion. J Clin Invest. 1944;23:613-627 344. von Kobyletzki D, Dalhoff A, Lindemeyer H, Primavesi CA. Ticarcillin serum and tissue concentrations in gynecology and obstetrics. Infection. 1983;11:144-149 345. Moiel RH, Ryan JR. Tolbutamide orinase in human breast milk. Clin Pediatr.
346. Sagranes R, Waller ES, Goehrs HR. Tolmetin in breast milk. Drug Intell Clin Pharm.
347. Arnauld R. Etude du passage de la trimethoprime dans le lait maternel. Ouest Med.
348. Miller RD, Salter AJ. The passage of trimethoprim/sulpha-methoxazole into breast milk and its significance. Proceedings of the 8th International Congress of Chemotherapy,Athens. Hellenic Soc Chemother. 1974;1:687 349. Alexander FW. Sodium valproate and pregnancy. Arch Dis Child. 1979;54:240 350. von Unruh GE, Froescher W, Hoffman F, Niesen M. Valproic acid in breast milk: how much is really there? Ther Drug Monit. 1984;6:272-276 351. Anderson P, Bondesson U, Mattiasson I, Johansson BW. Verapamil and norverapamil in plasma and breast milk during breast feeding. Eur J Clin Pharmacol. 1987;31:625-627 352. Orme ML, Lewis PJ, de Swiet M, et al. May mothers given warfarin breast-feed their infants? Br Med J. 1977;1:1564-1565 353. Pons G, Francoual C, Guillet P, et al. Zolpidem excretion in breast milk. Eur J Clin 354. Wild CP, Pionneau FA, Montesano R, Mutiro CF, Chetsanga CJ. Aflatoxin detected in human breast milk by immunoassay. Int J Cancer. 1987;40:328-333 355. Maxwell SM, Apeagyei F, de Vries HR, et al. Aflatoxins in breast milk, neonatal cord blood and sera of pregnant women. J Toxicol Toxin Rev. 1989;8:19-29 356. Zarba A, Wild CP, Hall AJ, et al. Aflatoxin M1 in human breast milk from The Gambia, west Africa, quantified by combined monoclonal antibody immunoaffinitychromatography HPLC. Carcinogenesis. 1992;13:891-894 357. Stegink LD, Filer LJ Jr, Baker GL. Plasma, erythrocyte human milk levels of free amino acids in lactating women administered aspartame or lactose. J Nutr.
1979;109:2173-2181 358. Mangurten HH, Kaye CI. Neonatal bromism secondary to maternal exposure in a photographic laboratory. J Pediatr. 1982;100:596-598 359. Radisch B, Luck W, Nau H. Cadmium concentrations in milk and blood of smoking mothers. Toxicol Lett. 1987;36:147-152 360. Miyazaki T, Akiyama K, Kaneko S, Horii S, Yamagishi T. Chlordane residues in human milk. Bull Environ Contam Toxicol. 1980;25:518-523 361. Resman BH, Blumenthal P, Jusko WJ. Breast milk distribution of theobromine from chocolate. J Pediatr. 1977;91:477-480 362. Wolff MS. Occupationally derived chemicals in breast milk. Am J Ind Med.
363. Egan H, Goulding R, Roburn J, Tatton JO. Organo-chlorine pesticide residues in human fat and human milk. Br Med J. 1965;2:66-69 364. Quinby GE, Armstrong JF, Durham WF. DDT in human milk. Nature. 1965;207:726- 365. Bakken AF, Seip M. Insecticides in human breast milk. Acta Paediatr Scand.
366. Adamovic VM, Sokic B, Smiljanski MJ. Some observations concerning the ratio of the intake of organochlorine insecticides through food and amounts excreted in the milk ofbreast-feeding mothers. Bull Environ Contam Toxicol. 1978;20:280-285 367. Savage EP, Keefe TJ, Tessari JD, et al. National study of chlorinated hydrocarbon insecticide residues in human milk, USA. I. Geographic distribution of dieldrin,heptachlor, heptachlor epoxide, chlordane, oxychlordane, and mirex. Am J Epidemiol.
1981;113:413-422 368. Wilson DJ, Locker DJ, Ritzen CA, Watson JT, Schaffner W. DDT concentrations in human milk. Am J Dis Child. 1973;125:814-817 369. Bouwman H, Becker PJ, Cooppan RM, Reinecke AJ. Transfer of DDT used in malaria control to infants via breast milk. Bull World Health Organ. 1992;70:241-250 370. Stevens MF, Ebell GF, Psaila-Savona P. Organochlorine pesticides in Western Australian nursing mothers. Med J Aust. 1993;158:238-241 371. Emanuel B, Schoenfeld A. Favism in a nursing infant. J Pediatr. 1961;58:263-266 372. Simpson WJ, Tuba J. An investigation of fluoride concentration in the milk of nursing mothers. J Oral Med. 1968;23:104-106 373. Esala S, Vuori E, Helle A. Effect of maternal fluorine intake on breast milk fluorine content. Br J Nutr. 1982;48:201-204 374. Dreyfus-See G. Le passage dans le lait des aliments ou medicaments absorbes par denourrices. Rev Med Interne. 1934;51:198 375. Ando M, Hirano S, Itoh Y. Transfer of hexachlorobenzene (HCB) from mother to newborn baby through placenta and milk. Arch Toxicol. 1985;56:195-200 376. West RW, Wilson DJ, Schaffner W. Hexachlorophene concentrations in human milk.
Bull Environ Contam Toxicol. 1975;13:167-169 377. Rabinowitz M, Leviton A, Needelman H. Lead in milk and infant blood: a dose- response model. Arch Environ Health. 1985;40:283-286 378. Sternowsky JH, Wessolowski R. Lead and cadmium in breast milk. Higher levels in urban vs rural mothers during the first 3 months of lactation. Arch Toxicol. 1985;57:41-45 379. Namihira D, Saldivar L, Pustilnik N, Carreon GJ, Salinas ME. Lead in human blood and milk from nursing women living near a smelter in Mexico City. J Toxicol EnvironHealth. 1993;38:225-232 380. Baum CR, Shannon MW. Lead in breast milk. Pediatrics. 1996;97:932 381. Koos BJ, Longo LD. Mercury toxicity in the pregnant woman, fetus, and newborn infant. A review. Am J Obstet Gynecol. 1976;126:390-409 382. Amin-Zaki L, Elhassani S, Majeed MA, Clarkson TW, Doherty RA, Greenwood MR.
Studies of infants postnatally exposed to methylmercury. J Pediatr. 1974;85:81-84 383. Pitkin RM, Bahns JA, Filer LJ Jr, Reynolds WA. Mercury in human maternal and cord blood, placenta, and milk. Proc Soc Exp Biol Med. 1976;151:565-567 384. Hersh J, Bono JV, Padgett DE, Mancuso CA. Methyl methacrylate levels in the breast milk of a patient after total hip arthroplasty. J Arthroplasty. 1995;10:91-92 385. Stegink LD, Filer LJ Jr, Baker GL. Monosodium glutamate: effect on plasma and breast milk amino acid levels in lactating women. Proc Soc Exp Biol Med. 1972;140:836-841 386. Miller RW. Pollutants in breast milk: PCBs and cola-colored babies [editorial]. J 387. Rogan WJ, Bagniewska A, Damstra T. Pollutants in breast milk. N Engl J Med.
388. Wickizer TM, Brilliant LB, Copeland R, Tilden R. Polychlorinated biphenyl contamination of nursing mothers' milk in Michigan. Am J Public Health. 1981;71:132-137 389. Brilliant LB, Van Amburg G, Isbister J, Bloomer AW, Humphrey H, Price H. Breast- milk monitoring to measure Michigan's contamination with polybrominated biphenyls.
Lancet. 1978;2:643-646 390. Wickizer TM, Brilliant LB. Testing for polychlorinated biphenyls in human milk.
391. Bagnell PC, Ellenberg HA. Obstructive jaundice due to a chlorinated hydrocarbon in breast milk. Can Med Assoc J . 1977;117:1047-1048 392. Higginbottom MC, Sweetman L, Nyhan WL. A syndrome of methylmalonic aciduria, homocystinuria, megaloblastic anemia neurologic abnormalities in a vitamin B12-deficient breast-fed infant of a strict vegetarian. N Engl J Med. 1978;299:317-323 TABLA 1
Drogas citotóxicas que pueden interferir con el Metabolismo celular del Niño Lactante
Motivo de preocupación, Se informa de signos y síntomas en el Referencia Posible supresión inmunitaria; efecto desconocido sobre el crecimiento o asociación con carcinogenesis , neutropenia Posible supresión inmunitaria; efecto desconocido sobre el crecimiento o asociación con carcinogenesis Posible supresión inmunitaria; efecto desconocido sobre el crecimiento o asociación con carcinogenesis Posible supresión inmunitaria; efecto desconocido sobre el crecimiento o asociación con carcinogenesis, neutropenia * El medicamento se concentra en la leche humana TABLA 2
Drogas de abuso en las se ha informado efectos adversos sobre el niño lactado *
Efecto informado o motivo de preocupación Intoxicación cocaína: irritabilidad, vómitos, diarrea, Temblores, inquietud, vómitos, alimentación pobre Solo 1 informe en la literatura, no efectos mencionados; larga 35vida media para algunos componentes • El Comité de Medicamentos cree fuertemente que las madres no deben ingerir drogas de abuso, porque ellos son peligrosas para la el niño y la salud de la madre • †La Drogas se concentran en la leche humana • TABLA 3
Componentes Radioactivos que requieren cese temporal de la Lactancia * Radiactividad en leche presente durante 2 Muy pequeña cantidad presente por 20 horas 39 Radiactividad en leche presente hasta 36 Si es usado para tratamiento de Cáncer de tiroides, la alta radiactividad puedeprolongar la exposición en el niño Radiactividad en leche presente 15 h a 3 d *Consultar con medico de medicina nuclear antes de realizar un estudio diagnostico para que seutilice el radionucleido que tenga más corta excreción por la leche humana. Antes del estudio lamadre debe extraerse mediante bomba en su pecho y almacenar la suficiente leche en elfrigorífico para alimentar al niño, después del estudio la madre debe extraerse su leche paramantener la producción de la misma, pero debe descartarse para su uso toda la leche obtenidadurante el tiempo que permanezca la radiactividad en la misma. Las muestras de leche puedenser analizadas por departamentos de radiología antes de la reanudación de la lactancia.
TABLA 4
Medicamentos que el efecto sobre el niño lactado es desconocido pero puede ser de
preocupación *
Cólico, irritabilidad, desordenes sueño y alimentación, Galactorrea en madre; somnolencia y letargia en niño; Posible supresión idiosincrasia de medula ósea Potencial por trasferirse en alto porcentaje de la dosis maternal, posible incremento de la pigmentación de lapiel Potencial concentraciones terapéuticas sericas en niños Ninguno descrito; agentes bloqueantes dopaminergico Efecto mutágeno In Vitro; puede suspenderse la lactancia 113, 114por 14-24 horas para permitir la excreción de la dosis,cuando a la madre se le administra una única dosis • Los medicamentos Psicotropicos, los compuestos listados bajo la categoría de ansiolíticos, antidepresivos y antipsicoticos son de especial preocupación cuando se dan a madres quelactan por largos periodos. Aunque hay muy pocos casos que informen de efectos adversosen niños con lactancia materna estos medicamentos aparecen en la leche humana y de estamanera pueden alterar a corto y largo plazo la función del Sistema Nervioso central.56 Verdiscusión en el texto de drogas psicotropicas.
† El medicamento se concentra en la leche humana en concentraciones próximas a lasconcentraciones plasmáticas simultaneas de la madre.
• TABLA 5
Medicamentos que han estado asociados con efectos significativos sobre algunos niñoslactados y debe ser dados con preocupación a las madres que lactan* Suprime la lactancia; puede ser peligroso para Somnolencia, irritabilidad, rechazo a la alimentación, grito agudo, rigidez del cuello (1caso) Vómitos, diarrea, convulsiones (dosis usadas en 131medicación de la migraña) 1/ 3 a 1/2 de la concentración terapéutica protombina y tromboplastina en 1 niño: no seusa en Estados Unidos Sedación; espasmos infantiles después del destete de leche conteniendo fenobarbital,metahemoglobinemia ( 1 CASO) * La concentración en sangre puede ser de importancia clínica.
TABLA 6
Medicación Maternal usualmente compatible con la lactancia*
Signos informados o síntomas en el niño diaforesis sueño profundo, debilidad,disminución de velocidad de crecimiento,anormal ganancia de peso, la ingestiónmaternal de 1 g/kg diariamentedisminuye el reflejo de eyección de leche Irritabilidad, patrones pobres de sueño, excretada lentamente, no efecto coningesta moderada de bebidas de café (2-3tazas por día) disminución en la producción de leche ycontenido proteico ( no confirmado envarios estudios) sericos de calcio si la madre recibe dosisfarmacológicas Isoefedrinapheniramine maleato con d- madre que lacta; los niños no deben serlactados por 48 horas materna , olor de yodo en la piel del niño Ninguno; su metabolito acetilo sé excreta 214, 261pero no se informa de hepatotoxicidad enlactantes glucosa-6-fosfato deshidrogenasa (G-6-PD) Precaución en lactantes con Ictericia o deficit G-6 Fosfato deshidrogenasa conictericia o deficit G-6-PD y enfermos ,estresados o lactantes prematuros apareceen la leche materna deficit G-6 Fosfato deshidrogenasa conictericia o déficit G-6-PD y enfermos ,estresados o lactantes prematuros apareceen la leche materna Ninguno; absorción insignificante por el * Los medicamentos de la lista que se ha informado con efectos en la literatura o no efecto. Lapalabra “ ninguno” significa que no se observan cambios en niño lactado mientras la madretoma el medicamento. La línea indica que no se menciona efecto clínico sobre el lactante. Sedebe resaltar que mucha de las citas se refiere a un único caso o una pequeña serie de lactantes.
† Medicamento se concentra en la leche humana.
TABLE 7
Alimentos y Agentes ambientales : Efectos sobre la lactancia materna
Irritabilidad o incremento de la motilidad intestinal si se excede la cantidad de ( >16oz/d) consumida por la madre Hemólisis en pacientes con déficit G-6-PD 371 Rash cutáneo , diarrea, vómitos, orina Ninguna; posible contaminación de la leche 376del lavado del pezón Falta de resistencia, hipotonía, malhumor, The recommendations in this statement do not indicate an exclusive course of treatment or serveas a standard of medical care. Variations, taking into account individual circumstances, may beappropriate.
Copyright 2001 by the American Academy of Pediatrics. No part of this statement may bereproduced in any form or by any means without prior written permission from the AmericanAcademy of Pediatrics except for one copy for personal use.
Esta traducción ha sido realizada por Juan Ruiz-Canela , revisada por Juan Aº Guerra ( Medicode Familia ) y Teresa Rodríguez (Farmacéutica) con un objetivo docente y divulgativo. Serecomienda a los clínicos verificarla con la traducción original en caso de duda.
En Algunas ocasiones el medicamento no respeta el orden alfabético y algunos productos noestán disponibles comercialmente en España

Source: http://www.cymsa.com.ar/pdf/lactancia/lactancia_drogas_aap.pdf