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Do medications pass from mother's blood to milk?
Although the passage of drugs from maternal plasma to milk is hampered by many structural barriers, e.g. cell membranes, interstitial fluid, and capillary endothelium, most substances ingested by breastfeeding mothers are more or less excreted in milk. What concentration the drug reaches in breast milk depends on the dose of the drug given to the mother, solubility of the drug in lipids, binding of the drug to blood proteins, pH of breast milk and molecular weight of the drug.
Drugs taken during lactation can be divided into 4 categories:
Category 1
Breastfeeding is possible and no risk to the baby is to be expected.
(diclofenac, ibuprofen, lidocaine, insulin, heparin, bisacodyl, gentamicin, quinine)
Category 2
Risk assessment is required when using this group of drugs. Feeding is possible provided that the child is well observed and undergoing control tests.
(caffeine, indomethacin, meta don, paracetamol, furosemide, loperamide, streptomycin)
Category 3
One-off or short-term use of this group of drugs is possible, however, with long-term therapy, breast-feeding should be discontinued.
(morphine, clemastine, codeine, sum tryptane, metronidazole)
Category 4
Taking this group of medicines cannot be reconciled with breastfeeding, therefore it is advisable to stop feeding, stop feeding or stop taking the medicine.
(loratadine, fluconazole, metoclopramide, ergotamine, bupropion, methotrexate, ofloxacin, lincomycin, clarithromycin)
In any case of taking any medications during lactation, you should consult your doctor.
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