Source: Ward KE. Pregnancy and lactation: therapeutic considerations. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146066717. Accessed May 17, 2017.
Medications enter breast milk via passive diffusion of nonionized and non-protein-bound medication.
Drugs with high molecular weights, lower lipid solubility, and higher protein binding less likely to cross into breast milk or transfer more slowly.
The higher the serum concentration of drug in mother’s serum, the higher the concentration in breast milk.
Drugs with longer half-lives maintain higher levels in breast milk.
Timing and frequency of feedings and amount of milk ingested by infant important considerations.
TREATMENT: GENERAL APPROACH
TREATMENT: NONPHARMACOLOGIC THERAPY
TREATMENT: PHARMACOLOGIC THERAPY