ABSTRACT
It is possible to determine the safety of medication according to pharmacokinetics. This chapter presents a summary to enable practitioners to determine compatibility of medication with breastfeeding. Very few drugs are licensed for use in breastfeeding. There is some evidence of a genetic predisposition to the development of inflammatory bowel disease (IBD) and the use of formula milk particularly in early puerperium, so mothers may be keen to avoid any drug necessitating cessation/interruption of breastfeeding. Babies of mothers with IBD on monoclonal antibodies should avoid live vaccines, especially rotavirus due to shedding into faeces. Laxatives that are compatible with breastfeeding include: bulk-forming laxatives and osmotic laxatives. Antihistamines are widely used by breastfeeding mothers to relieve the symptoms of hayfever. The use of hypnotics is problematic as the drugs will almost inevitably cross the blood–brain barrier and cause drowsiness in the infant. Maternal smoking is one of the highest risks for sudden infant death syndrome.
