BREASTFEEDING Flashcards
(33 cards)
BREASTFEEDING
how long should infants be exclusively breastfed for?
6 months
BREASTFEEDING
what are the risks for the infant if they are not breastfed?
increased risk of:
- asthma + atopic illness
- D+V
- necrotising enterocolitis (NEC)
- obesity + CVD later in life
- otitis media, Hib meningitis, UTIs
- sudden infant death syndrome
- T1DM + T2DM
also increases IQ
BREASTFEEDING
what are the risks to the mother if not breastfeeding?
increased risk of:
- breast + ovarian cancer
- CVD
- obesity
- osteoporosis
- postnatal depression
- post-partum haemorrhage
- T2DM
PHARMACOLOGY
what things should you consider when prescribing in breastfeeding?
- age of the baby (hepatic + renal function improve after a few weeks of life)
- whether baby has co-morbidities
- whether mother is taking medications + what it is
- how often baby is breastfed
PHARMACOLOGY
what drug characteristics are compatible with breastfeeding?
- high molecular weight
- high protein binding
- low lipid solubility
- lower pH
VACCINES
which vaccines are not compatible with breastfeeding?
yellow fever
all other vaccines are deemed compatible with breastfeeding
LACTATION SUPPRESSION
what medication can be given to stop milk supply?
cabergoline 1mg single dose on 1st day postpartum
a small number of women may require 2 doses
SHOULD NOT BE GIVEN IN HTN/PRE-ECLAMPSIA
LACTATION SUPPRESSION
what medication can be given to suppress lactation that is already established?
cabergoline 250mg every 12hrs for 2 days
LACTATION ENHANCEMENT
what drug can be prescribed to increase milk supply?
metoclopramide
ANTIBIOTICS
which antibiotics can be used in breastfeeding to treat UTIs?
- trimethoprim
- amoxicillin
- cefalexin
ANTIBIOTICS
which antibiotic is contraindicated in breastfeeding?
nitrofurantoin (if infant <3 months old)
ANALGESIA
are NSAIDs safe during breastfeeding?
yes they are safe
ANALGESIA
are opioids safe in breastfeeding?
no - should be avoided if possible
if opioid is required, infant should be closely observed for sedation, poor-feeding and respiratory depression
ANALGESIA
is codeine safe in breastfeeding?
no it is contraindicated
ANALGESIA
is paracetamol safe in breastfeeding?
yes - it is safe
ANALGESIA
is aspirin safe in breastfeeding?
generally avoided due to risk of Reye’s syndrome
at antiplatelet doses it is believed to be safe
ANALGESIA
is dihydrocodeine safe in breasfeeding?
alternative should be used if possible
if it is used, the infant should be closely observed for sedation, poor feeding and respiratory depression
ANALGESIA
is tramadol safe in breastfeeding?
yes - it is safe
mother should be alert to increased sleepiness, limpness, poor feeding or breathing difficulties in infant
ANTIDEPRESSANTS
is TCAs safe in breastfeeding?
yes (all other than doxepin) - if baby is full term and health
infant should be monitored for sedation, poor feeding + behavioural disturbances
avoid other sedating agents as sedation can be additive
ANTIDEPRESSANTS
what are the first line options for antidepressants when breastfeeding?
SSRIs = sertraline or paroxetine
ANTIDEPRESSANTS
is fluoxetine safe in breastfeeding?
no - it should not be used
ANTIDEPRESSANTS
are MAOIs (e.g. phenelzine) safe in breastfeeding?
no - should not be used
ANTIDEPRESSANTS
are SSRIs and SNRIs safe in breastfeeding?
yes - they are safe
CONTRACEPTION
when can POP be used?
any time after delivery
