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