The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics

Sachs, Hari Cheryl

doi:10.1542/peds.2013-1985

Cited by 468 publications

(240 citation statements)

References 97 publications

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211

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“…Recommendations regarding the support of breastfeeding and potential effects on the newborn brain from passage of these substances warrant additional investigation and consensus. 59 In a perfect health care system, the mother's health history would include sequential screening for alcohol, tobacco, and substance use throughout the pregnancy, and obstetric providers would communicate concerns to the pediatric team caring for the infant. With potentially concerning information, the discharging medical team might offer the mother resources to support her intentions of becoming a good parent for the infant with substance exposure.…”

Section: Methods To Assess and Engage The Family Affected By Parentalmentioning

confidence: 99%

Families Affected by Parental Substance Use

Smith¹,

Wilson²,

Ryan³

et al. 2016

Pediatrics

162

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Children whose parents or caregivers use drugs or alcohol are at increased risk of short- and long-term sequelae ranging from medical problems to psychosocial and behavioral challenges. In the course of providing health care services to children, pediatricians are likely to encounter families affected by parental substance use and are in a unique position to intervene. Therefore, pediatricians need to know how to assess a child’s risk in the context of a parent’s substance use. The purposes of this clinical report are to review some of the short-term effects of maternal substance use during pregnancy and long-term implications of fetal exposure; describe typical medical, psychiatric, and behavioral symptoms of children and adolescents in families affected by substance use; and suggest proficiencies for pediatricians involved in the care of children and adolescents of families affected by substance use, including screening families, mandated reporting requirements, and directing families to community, regional, and state resources that can address needs and problems.

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Section: Methods To Assess and Engage The Family Affected By Parentalmentioning

confidence: 99%

Families Affected by Parental Substance Use

Smith¹,

Wilson²,

Ryan³

et al. 2016

Pediatrics

162

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“…156 This position was further reaffirmed in 2013. 157 Multiple studies have validated the finding that breast milk contains only minimal quantities of methadone and buprenorphine. [158][159][160] Obstetricians and lactation specialists also have endorsed breastfeeding among opioidaddicted mothers.…”

Section: Breastfeedingmentioning

confidence: 99%

Neonatal Abstinence Syndrome

2014

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Neonatal abstinence syndrome (NAS) is a result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during pregnancy. Withdrawal from licit or illicit substances is becoming more common among neonates in both developed and developing countries. NAS continues to be an important clinical entity throughout much of the world. NAS leads to a constellation of signs and symptoms involving multiple systems. The pathophysiology of NAS is not completely understood. Urine or meconium confirmation may assist the diagnosis and management of NAS. The Finnegan scoring system is commonly used to assess the severity of NAS; scoring can be helpful for initiating, monitoring, and terminating treatment in neonates. Nonpharmacological care is the initial treatment option, and pharmacological treatment is required if an improvement is not observed after nonpharmacological measures or if the infant develops severe withdrawal. Morphine is the most commonly used drug in the treatment of NAS secondary to opioids. An algorithmic approach to the management of infants with NAS is suggested. Breastfeeding is not contraindicated in NAS, unless the mother is taking street drugs, is involved in polydrug abuse, or is infected with HIV. Future studies are required to assess the long-term effects of NAS on children after prenatal exposure.

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“…Ibuprofen is not detected in breastmilk following doses up to 1.6 g/day and is regarded as compatible with breastfeeding. 13 …”

Section: Pharmacologic Managementmentioning

confidence: 99%

ABM Clinical Protocol #4: Mastitis, Revised March 2014

Amir

2014

Breastfeeding Medicine

170

173

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A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

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The Transfer of Drugs and Therapeutics Into Human Breast Milk: An Update on Selected Topics

Cited by 468 publications

References 97 publications

Families Affected by Parental Substance Use

Families Affected by Parental Substance Use

Neonatal Abstinence Syndrome

ABM Clinical Protocol #4: Mastitis, Revised March 2014

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