BF Section 7: Contraindications in breastfeeding

when should mother's be advised to take prescribed medications?

immediately following breastfeeding so the medication level in the breastmilk is low at the time of the next feed

drugs in category C: not considered hazardous

insulin, epinephrine, acetaminophen, alcohol (in moderation), caffeine (in moderation), nicotine (in moderation)

maternal chickenpox occurs and no apparent lesions are on the infant, mother and infant should be _____

isolated separately

in a mother with HSV, breastfeeding is permitted if?

no active lesions present on the breast

Rifampin has ____ on breastmilk

no effect

when a mother is diagnosed with TB prior to delivery, baby and mother must be ______

separated to prevent the infant from contracting the disease

a mother diagnosed with breast cancer ______ _____ breastfeed her infant

should not BF - will need specific treatment for the disease

____ exists breastmilk

HIV

what commonly abused drugs are contraindicated in breastfeeding?

amphetamines, cocaine, heroin, marijuana, nicotine, phencyclidine hydrochloride (PCP, angel dust)

if active genital herpes is present what is done?

Caesarean section

if a mother is diagnosed with active TB she should be treated with what?

INH and Rifampin

women with contraindications are advised to stop breastfeeding ______ or ______

temporarily or permanently

when may breastfeeding resume in a mother diagnosed with active TB?

after mother complied with treatment of INH and Rifampin for 2+ weeks and the infant is receiving INH prophylactically

what are true contraindications in breastfeeding?

1) breast cancer 2) HIV/AIDs 3) galactosemia 4) untreated TB 5) maternal chickenpox 6) herpes (only if in direct contact with an open lesion) 7) contraindicated drugs

most common situations in which mothers are given inappropriate advice to stop breastfeeding include: (3)

1) during some drug therapies 2) infectious diseases 3) phenylketonuria (PKU)

what are the 3 categories of drugs for mothers

A) generally contraindicated in breastfeeding B) not contraindicated but requiring close observation C) not considered hazardous

Drugs in category A: generally contraindicated in breastfeeding

Atropine, antineoplastic agents, cathartics (excluding Senna), iodides, mercurials, radioactive agents, bromides, ergot, tetracycline and phenindione (anticoagulant)

current recommendations suggest: maternal antiviral treatment and infant prophylaxis is recommended over avoidance of breastfeeding in mother's with ____

HIV/AIDs

what is Rifampin?

antibiotic used to treat TB

what are contraindications for breastfeeding?

any element that could put a mother or her infant at significant risk

TB treatment, INH is secreted into ________, no reports of adverse effects to infants in mother's taking this drug

breastmilk

What is galactosemia?

congenital metabolic disorder in which there is an inability to metabolize galactose

Drugs in category B: not contraindicated but requiring close observation

corticosteroids, diuretics, reserpine, diazepam, nalidixic acid, phenytoin sulphonamides, barbiturates, lithium carbonate, salicylate, antibiotics and chlorpromazine

breastfeeding history ______ influence breast cancer likelihood

does not

What does Galactosemia cause

failure to thrive, hepatomegaly, and splenomegaly

HSV infection in the newborn can be

fatal

in the severe form of galactosemia, it can be ________

fatal

an infant with galactosemia must be placed on what type of diet?

galactose-free diet

why should mothers with breast cancer not breastfeed?

high levels of prolactin and sex steroids can accelerate malignant growth

what level of risk is present to an infant born vaginally to a mother with active genital herpes?

high risk

infants with galctosemia cannot have human breastmilk because?

human milk is high in lactose

breastfeeding mothers should be aware that drugs they ingest have the potential to what?

pass into breastmilk

how is neonatal herpes transmitted?

via direct contact with an active lesion, NOT via breastmilk

babies with galactosemia must be ________ and place on what?

weaned from the breast and placed on a special formula

how soon are chicken pox antibodies present in milk after onset of disease?

within 48 hours