AMERICAN ACADEMY OF PEDIATRICS
Committee on Drugs
The Transfer of Drugs and Other Chemicals Into Human Milk
ABSTRACT. The American Academy of Pediatrics places emphasis on increasing breastfeeding in the United States. A common reason for the cessation of breastfeeding is the use of medication by the nursing mother and advice by her physician to stop nursing. Such advice may not be warranted. This statement is intended to supply the pediatrician, obstetrician, and family physician with data, if known, concerning the excretion of drugs into human milk. Most drugs likely to be prescribed to the nursing mother should have no effect on milk supply or on infant well-being. This information is important not only to protect nursing infants from untoward effects of maternal medication but also to allow effective pharmacologic treatment of breastfeeding mothers. Nicotine, psychotropic drugs, and silicone implants are 3 important topics reviewed in this statement. INTRODUCTION
statement on the transfer of drugs and chemicals into human milk was first published in 1983,1 with revisions in 19892 and 1994.3 Information continues to become available. The current statement is intended to revise the lists of agents transferred into human milk and describe their possible effects on the infant or on lactation, if known (Tables 1–7). If a pharmacologic or chemical agent does not appear in the tables, it does not mean that it is not transferred into human milk or that it does not have an effect on the infant; it only indicates that there were no reports found in the literature. These tables should assist the physician in counseling a nursing mother regarding breastfeeding when the mother has a condition for which a drug is medically indicated.
BREASTFEEDING AND SMOKING
In the previous edition of this statement, the Committee on Drugs placed nicotine (smoking) in Table 2, “Drugs of Abuse-Contraindicated During Breastfeeding.” The reasons for placing nicotine and, thus, smoking in Table 2 were documented decrease in milk production and weight gain in the infant of the smoking mother and exposure of the infant to environmental tobacco smoke as demonstrated by the presence of nicotine and its primary metabolite, cotinine, in human milk.4 –12 There is controversy regarding the effects of nicotine on infant size at 1 year of age.13,14 There are hundreds of compounds in tobacco smoke; however, nicotine and its metabolite acotinine are most often used as markers of tobacco
The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. PEDIATRICS (ISSN 0031 4005). Copyright © 2001 by the American Academy of Pediatrics.
exposure. Nicotine is not necessarily the only component that might cause an increase in respiratory illnesses (including otitis media) in the nursing infant attributable to both transmammary secretion of compounds and environmental exposure. Nicotine is present in milk in concentrations between 1.5 and 3.0 times the simultaneous maternal plasma concentration,15 and elimination half-life is similar— 60 to 90 minutes in milk and plasma.7 There is no evidence to document whether this amount of nicotine presents a health risk to the nursing infant. The Committee on Drugs wishes to support the emphasis of the American Academy of Pediatrics on increasing breastfeeding in the United States. Pregnancy and lactation are ideal occasions for physicians to urge cessation of smoking. It is recognized that there are women who are unable to stop smoking cigarettes. One study reported that, among women who continue to smoke throughout breastfeeding, the incidence of acute respiratory illness is decreased among their infants, compared with infants of smoking mothers who are bottle fed.16 It may be that breastfeeding and smoking is less detrimental to the child than bottle feeding and smoking. The Committee on Drugs awaits more data on this issue. The Committee on Drugs therefore has not placed nicotine (and thus smoking) in any of the Tables but hopes that the interest in breastfeeding by a smoking woman will serve as a point of discussion about smoking cessation between the pediatrician and the prospective lactating woman or nursing mother. Alternate (oral, transcutaneous) sources of nicotine to assist with smoking cessation, however, have not been studied sufficiently for the Committee on Drugs to make a recommendation for or against them in breastfeeding women.
Anti-anxiety drugs, antidepressants, and neuroleptic drugs have been placed in Table 4, “Drugs for Which the Effect on Nursing Infants is Unknown but May Be of Concern.” These drugs appear in low concentrations (usually with a milk-to-plasma ratio of 0.5–1.0) in milk after maternal ingestion. Because of the long half-life of these compounds and some of their metabolites, nursing infants may have measurable amounts in their plasma and tissues, such as the brain. This is particularly important in infants during the first few months of life, with immature hepatic and renal function. Nursing mothers should be informed that if they take one of these drugs, the infant will be exposed to it. Because these drugs affect neurotransmitter function in the developing central
PEDIATRICS Vol. 108 No. 3 September 2001
MD American Academy of Child and Adolescent Psychiatry Stuart M. or liquid. MD American College of Obstetricians and Gynecologists Sumner J. Concern has been raised about the possible effects to the nursing infant if mothers with implants breastfeed. Koteras. the method used for laboratory identification.html) and to the Committee on Drugs.22 The anticolic compound simethicone is a silicone and has a structure very similar to the methyl polydimethylsiloxane in breast implants. Drugs cited in Tables 1 through 7 are listed in alphabetical order by generic name. MD Food and Drug Administration Owen R.18 This finding has not been confirmed by other reports. PhD American Medical Association/United States Pharmacopeia Therese Cvetkovich.
SILICONE BREAST IMPLANTS AND BREASTFEEDING
Approximately 800 000 to 1 million women in the United States have received breast implants containing silicone (elemental silicon with chemical bonds to oxygen) in the implant envelope or in the envelope and the interior gel. Ring. This concern was initially raised in reports that described esophageal dysfunction in 11 children whose mothers had implants. consultation between the pediatrician and the mother’s physician can be most useful in determining what options to choose. Volume I.17. MD. Chairperson Brian A. This communication should include the generic and brand names of the drug. Hagino. Ward. Bennett. Walls. concern also exists that toxicity may be mediated through an immunologic mechanism. Riley. MD. Berlin. If there is a possibility that a drug may present a risk to the infant.24 and USP Dictionary of USAN and International Drug Names. Is drug therapy really necessary? If drugs are required.20 There is no evidence at the present time that this polymer is directly toxic to human tissues. acetaminophen rather than aspirin for analgesia. Yaffe. MD William E. MD David J. the concentration of the drug in milk and maternal and infant blood in relation to the time of ingestion. brand names are available from the current Physicians’ Desk Reference. MD. there have been no other reports of clinical problems in infants of mothers with silicone breast implants. MD Section on Allergy and Immunology Consultant Cheston M. 2000 –2001 Robert M. Walson. the polymer involved in the covering and the interior of the breast implant consists of a polymer of alternating silicon and oxygen atoms with methyl groups attached to the oxygen groups (methyl polydimethylsiloxane). PhD Canadian Paediatric Society Siddika Mithani. Such reports may substantially increase the pediatric community’s fund of knowledge regarding drug transfer into human milk and the potential or actual risk to the infant. the age of the infant. MD John C. The safest drug should be chosen. PhD Philip D. and the adverse effects. Silicone chemistry is extremely complex.
Committee on Drugs. gel.gov/medwatch/index. MD. 2. Jr. however. Except for the study cited above.21 It is unlikely that elemental silicon causes difficulty. MSPH Centers for Disease Control and Prevention Laura E. MacLeod.25 The reference list is not inclusive of all articles published on the topic. Cote ´ . Simethicone has been used for decades in this country and Europe without any evidence of toxicity to infants. MD National Institutes of Health Section Liaisons Charles J.fda. MD Section on Anesthesiology Eli O.
DRUG THERAPY OF THE LACTATING WOMAN
quantitate drugs in milk continue to improve. Physicians who encounter adverse effects in infants who have been receiving drug-contaminated human milk are urged to document these effects in a communication to the Food and Drug Administration (http://www. Meltzer. Burchfield. The Committee on Drugs does not feel that the evidence currently justifies classifying silicone implants as a contraindication to breastfeeding. Drug exposure to the nursing infant may be minimized by having the mother take the medication just after she has breastfed the infant or just before the infant is due to have a lengthy sleep period. Canada Joseph Mulinare. This has yet to be confirmed in humans.23 USP DI 2001: Drug Information for the Health Care Professional. consideration should be given to measurement of blood concentrations in the nursing infant. MD Staff Raymond J. Bates. MD Bureau of Pharmaceutical Assessment Health Protection Branch. 3. MD. it may not be possible to predict long-term neurodevelopmental effects. There are only a few instances of the polymer being assayed in the milk of women with implants.nervous system. MD Food and Drug Administration Alternate Donald R. because silicon is present in higher concentrations in cow milk and formula than in milk of humans with implants. 4.19 The length of the polymer determines whether it is a solid. the concentrations are not elevated over control samples. the maternal dose and mode of administration. MD Richard P. MD Liaisons John Alexander. Benitz. this information will require frequent updating. for example. MHA AMERICAN ACADEMY OF PEDIATRICS 777
The following should be considered before prescribing drugs to lactating women: 1. Data have been obtained from a search of the medical literature. Because methodologies used to
poor sleeping pattern Cocaine intoxication: irritability. depending on study If used for treatment of thyroid cancer. vomiting. because they are hazardous to the nursing infant and to the health of the mother. unknown effect association with carcinogenesis Possible immune suppression. after study. unknown effect association with carcinogenesis Possible immune suppression. very long half-life for some components Potent hallucinogen Reference No. 37 38 39 40. poor feeding Only 1 report in literature. 41 42 43–46 47. the mother should pump her breast to maintain milk production but discard all milk pumped for the required time that radioactivity is present in milk.TABLE 1. unknown effect association with carcinogenesis. diarrhea. Before study. neutropenia Possible immune suppression. restlessness. seizures Tremors. high radioactivity may prolong exposure to infant Radioactivity in milk present 96 h Radioactivity in milk present 15 h to 3 d Reference No. unknown effect association with carcinogenesis. 99mTc O4
* Consult nuclear medicine physician before performing diagnostic study so that radionuclide that has the shortest excretion time in breast milk can be used.
Radioactive Compounds That Require Temporary Cessation of Breastfeeding* Compound Recommended Time for Cessation of Breastfeeding Radioactivity in milk present at 50 h Radioactivity in milk present for 2 wk Very small amount present at 20 h Radioactivity in milk present up to 36 h Radioactivity in milk present for 12 d Radioactivity in milk present 2–14 d. Reported Sign or Symptom in Infant. neutropenia on growth or on growth or on growth or on growth or Reference No.
TABLE 3. or Effect on Lactation Possible immune suppression. † Drug is concentrated in human milk.
Cytotoxic Drugs That May Interfere With Cellular Metabolism of the Nursing Infant Drug Reason for Concern.
TABLE 2. 26. tremulousness. 32 33 34 35 36
Amphetamine† Cocaine Heroin Marijuana Phencyclidine
* The Committee on Drugs strongly believes that nursing mothers should not ingest drugs of abuse. 48 49 41. 50–55
Copper 64 (64Cu) Gallium 67 (67Ga) Indium 111 (111In) Iodine 123 (123I) Iodine 125 (125I) Iodine 131 (131I) Iodine131 Radioactive sodium Technetium 99m (99mTc). 27 28. 29 30 31
Cyclophosphamide Cyclosporine Doxorubicin* Methotrexate * Drug is concentrated in human milk. the mother should pump her breast and store enough milk in the freezer for feeding the infant. Milk samples can be screened by radiology departments for radioactivity before resumption of nursing. 99mTc macroaggregates. no effect mentioned.
Drugs of Abuse for Which Adverse Effects on the Infant During Breastfeeding Have Been Reported* Drug Reported Effect or Reasons for Concern Irritability.
THE TRANSFER OF DRUGS AND OTHER CHEMICALS INTO HUMAN MILK
70 71 72 73 74. 114 115
Anti-anxiety Alprazolam Diazepam Lorazepam Midazolam Perphenazine Prazepam† Quazepam Temazepam Antidepressants Amitriptyline Amoxapine Bupropion Clomipramine Desipramine Dothiepin Doxepin Fluoxetine Fluvoxamine Imipramine Nortriptyline Paroxetine Sertraline† Trazodone Antipsychotic Chlorpromazine Chlorprothixene Clozapine† Haloperidol Mesoridazine Trifluoperazine OTHERS Amiodarone Chloramphenicol Clofazimine Lamotrigine Metoclopramide† Metronidazole Tinidazole
None None None — None None None — None None None None None None None Colic. infantile spasms after weaning from milk containing phenobarbital. may discontinue breastfeeding for 12–24 h to allow excretion of dose when single-dose therapy given to mother See metronidazole
* Psychotropic drugs. dopaminergic blocking agent In vitro mutagen.
AMERICAN ACADEMY OF PEDIATRICS
. 108 109 110 111. feeding and sleep disorders. irritability. and antipsychotic categories. 126 127–129 130 131 132–134 135 136–140 136. 75 76. slow weight gain — None None None None None Galactorrhea in mother. diarrhea. these drugs do appear in human milk and. 137 141
* Blood concentration in the infant may be of clinical importance. tachypnea Diarrhea (1 case) Cyanosis. 93 94 95–98 99 100 101–104 105 104 106 107. possible increase in skin pigmentation Potential therapeutic serum concentrations in infant None described. drowsiness and lethargy in infant.
Drugs for Which the Effect on Nursing Infants Is Unknown but May Be of Concern* Drug Reported or Possible Effect Reference No. high-pitched cry. bradycardia.
TABLE 5. methemoglobinemia (1 case) Sedation. Although there are very few case reports of adverse effects in breastfeeding infants. irritability. 112 113. 90 91 92. Drugs That Have Been Associated With Significant Effects on Some Nursing Infants and Should Be Given to Nursing Mothers With Caution* Drug Acebutolol 5-Aminosalicylic acid Atenolol Bromocriptine Aspirin (salicylates) Clemastine Ergotamine Lithium Phenindione Phenobarbital Primidone Sulfasalazine (salicylazosulfapyridine) Reported Effect Hypotension.56 See discussion in text of psychotropic drugs. refusal to feed. 77 78 79–87 88 74 89. the compounds listed under anti-anxiety. may be hazardous to the mother Metabolic acidosis (1 case) Drowsiness. not used in United States Sedation. are of special concern when given to nursing mothers for long periods. 57 58–62 63 64 65 66 67 68 69.TABLE 4. † Drug is concentrated in human milk relative to simultaneous maternal plasma concentrations. could conceivably alter short-term and long-term central nervous system function. feeding problems Bloody diarrhea (1 case) Reference No. decline in developmental scores None None Decline in developmental scores None None Possible hypothyroidism Possible idiosyncratic bone marrow suppression Potential for transfer of high percentage of maternal dose. bradycardia Suppresses lactation. antidepressant. convulsions (doses used in migraine medications) One-third to one-half therapeutic blood concentration in infants Anticoagulant: increased prothrombin and partial thromboplastin time in 1 infant. neck stiffness (1 case) Vomiting. 116 117–119 120–124 125. thus.
223 224 225 226. excreted slowly. deep sleep. vaginal bleeding None — Reference No. 198 199 30 200 201 144. poor sleeping patterns.4 g/d None Irritability. 193 194 195. maternal ingestion of 1 g/kg daily decreases milk ejection reflex — None — None — None None None None None See Table 5 Suppresses lactation None Rash. alcohol)
153 154 155 156 157 158 159 160–162 163 164 165 166 167 168 169–174 175 176. 156. poor sleeping pattern. absence of cry with maternal intake of 5. 180 181 154 182 183 183 184 185 186 187 188 189–191 192. 202 203–205 206–213 214 215–217 218 191. 219 220 221 222. 149–152
Acetaminophen Acetazolamide Acitretin Acyclovir† Alcohol (ethanol)
Allopurinol Amoxicillin Antimony Atropine Azapropazone (apazone) Aztreonam B1 (thiamin) B6 (pyridoxine) B12 Baclofen Barbiturate Bendroflumethiazide Bishydroxycoumarin (dicumarol) Bromide Butorphanol Caffeine Captopril Carbamazepine Carbetocin Carbimazole Cascara Cefadroxil Cefazolin Cefotaxime Cefoxitin Cefprozil Ceftazidime Ceftriaxone Chloral hydrate Chloroform Chloroquine Chlorothiazide Chlorthalidone Cimetidine† Ciprofloxacin Cisapride Cisplatin Clindamycin Clogestone Codeine Colchicine Contraceptive pill with estrogen/progesterone Cycloserine D (vitamin) Danthron Dapsone Dexbrompheniramine maleate with d-isoephedrine Diatrizoate Digoxin Diltiazem Dipyrone Disopyramide Domperidone Dyphylline† Enalapril Erythromycin† Estradiol Ethambutol Ethanol (cf. decrease in linear growth. diaphoresis. sulfonamide detected in infant’s urine Crying. decrease in milk production and protein content (not confirmed in several studies) None None. 196 197. no effect with moderate intake of caffeinated beverages (2–3 cups per day) None None None Goiter None None None None None — None None Sleepiness None None None Excreted slowly None None None Not found in milk None None None — Rare breast enlargement. 148 4. 142–144 145 146 147. weakness. weakness. 177 178 83. follow up infant’s serum calcium level if mother receives pharmacologic doses Increased bowel activity None. 179. drowsiness.
Maternal Medication Usually Compatible With Breastfeeding* Drug Reported Sign or Symptom in Infant or Effect on Lactation None None — None With large amounts. abnormal weight gain. irritability None None None None None None None — None Withdrawal.TABLE 6. 227 228 229 230 231 232 214
THE TRANSFER OF DRUGS AND OTHER CHEMICALS INTO HUMAN MILK
see iodine Goiter Elevated iodine levels in breast milk. 294 295 282. drug appears in infant serum — None — One 400-mg dose given to nursing mothers.TABLE 6. 193 252. 266 214 267 268 269. 255 256–258 259 259 259 97 260 214. 264 265.
Continued Drug Reported Sign or Symptom in Infant or Effect on Lactation None. 289 61 290 291 120 292 97 293. 233 234 235 236. 270 271–274 275 276 277 278 279 201. odor of iodine on infant’s skin None None None. 176. 296–298 299 300 301 302 303 304 305 306 307 308 198 309. 176. eg. in a vaginal douche) Iohexol Iopanoic acid Isoniazid Interferon-␣ Ivermectin K1 (vitamin) Kanamycin Ketoconazole Ketorolac Labetalol Levonorgestrel Levothyroxine Lidocaine Loperamide Loratadine Magnesium sulfate Medroxyprogesterone Mefenamic acid Meperidine Methadone Methimazole (active metabolite of carbimazole) Methohexital Methyldopa Methyprylon Metoprolol† Metrizamide Metrizoate Mexiletine Minoxidil Morphine Moxalactam Nadolol† Nalidixic acid Naproxen Nefopam Nifedipine Nitrofurantoin Norethynodrel Norsteroids Noscapine Ofloxacin Oxprenolol Phenylbutazone Phenytoin Piroxicam Prednisolone Prednisone
AMERICAN ACADEMY OF PEDIATRICS
. 261 262 263. infants not given breast milk for 48 h None None — None None None None None None — None None Seizure (1 case) May affect thyroid activity. 280 281 61. 315 316
Ethosuximide Fentanyl Fexofenadine Flecainide Fleroxacin Fluconazole Flufenamic acid Fluorescein Folic acid Gadopentetic (Gadolinium) Gentamicin Gold salts Halothane Hydralazine Hydrochlorothiazide Hydroxychloroquine† Ibuprofen Indomethacin Iodides Iodine Iodine (povidone-iodine. infant may have measurable blood concentration None None Hemolysis in infant with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency — None — Hemolysis in infant with G-6-PD deficiency None None None None None None Methemoglobinemia (1 case) None None None Reference No. acetyl (hepatotoxic) metabolite secreted but no hepatotoxicity reported in infants — None None None None — None — None None — None None None None None None None None None Drowsiness None None None None None None. 310 311 138. 282 283–287 288. 312 313 314. 253 254. 237 238 239 240 241 242 243 244 245–249 250 251 192.
benzene hexachlorides. The word “none” means that no observable change was seen in the nursing infant while the mother was ingesting the compound. hypotonia. stressed. vomiting.
TABLE 7. 373 374. It is emphasized that many of the literature citations concern single case reports or small series of infants. 334 335 336 337 338 235 339. drug not used in United States None None Possible jaundice None None None None None None None Reference No. dark urine.TABLE 6. 342 343 344 310 345 346 347. 361 362–370 371 372. possible contamination of milk from nipple washing Possible neurotoxicity May affect neurodevelopment None None Lack of endurance. dieldrin. 348 324 176. methylmercury Methylmethacrylate Monosodium glutamate Polychlorinated biphenyls and polybrominated biphenyls Silicone Tetrachloroethylene cleaning fluid (perchloroethylene) Vegetarian diet
THE TRANSFER OF DRUGS AND OTHER CHEMICALS INTO HUMAN MILK
. 349. or premature infant. or premature infant. sullen. Dashes indicate no mention of clinical effect on the infant. 340 169. diarrhea. see Table 6 None reported None reported Irritability or increased bowel activity if excess amounts (Ն16 oz/d) consumed by mother None Hemolysis in patient with G-6-PD deficiency None Skin rash. dark urine Signs of B12 deficiency Reference No. 317 318 319 320–322 323 324 325 326 191. aldrin. negligible absorption by infant Irritability None None mentioned. stressed.
Continued Drug Reported Sign or Symptom in Infant or Effect on Lactation None None None None None None None None None None None None — None None — None None None Caution in infant with jaundice or G-6-PD deficiency and ill. expressionless facies Esophageal dysmotility Obstructive jaundice. 341 139. 350 351 352 353
Procainamide Progesterone Propoxyphene Propranolol Propylthiouracil Pseudoephedrine† Pyridostigmine Pyrimethamine Quinidine Quinine Riboflavin Rifampin Scopolamine Secobarbital Senna Sotalol Spironolactone Streptomycin Sulbactam Sulfapyridine Sulfisoxazole Sumatriptan Suprofen Terbutaline Terfenadine Tetracycline Theophylline Thiopental Thiouracil Ticarcillin Timolol Tolbutamide Tolmetin Trimethoprim/sulfamethoxazole Triprolidine Valproic acid Verapamil Warfarin Zolpidem
* Drugs listed have been reported in the literature as having the effects listed or no effect. 375 376 377–380 381–383 384 385 386–390 17–22 391 392
Aflatoxin Aspartame Bromide (photographic laboratory) Cadmium Chlordane Chocolate (theobromine) DDT. 330 331 214 332 333. appears in infant’s milk None None None None None. appears in infant’s milk Caution in infant with jaundice or G-6-PD deficiency and ill. hepatachlorepoxide Fava beans Fluorides Hexachlorobenzene Hexachlorophene Lead Mercury.
Food and Environmental Agents: Effects on Breastfeeding Agent Reported Sign or Symptom in Infant or Effect on Lactation None Caution if mother or infant has phenylketonuria Potential absorption and bromide transfer into milk. death None. † Drug is concentrated in human milk. 354–356 357 358 359 360 169. neurotoxicity. 327 296 159 214 156 328 329 237.
Maisels MJ. 1988. McHugh A. Ferguson BB. Pommerenke WT. Villen T. 1973. Neutropenia from cyclophosphamide in breast milk. 1994. Excretion of technetium in human milk. 1998. Committee on Drugs. Alcohol and nicotine poisoning in nurslings. Am J Epidemiol. Weekes ME. Plum C. Hedrick WR. Wennergren M. Graham NM. Transplantation. Perez-Reyes M. Human breast milk excretion of radionuclides following administration of radiopharmaceuticals. Schulte-Hobein B.14:115–117 54. Luck W. Van Buren C. 1987.71:841– 842 56. USP Dictionary of USAN and International Drug Names. Br J Radiol. Pediatrics. Acta Paediatr.14:51–52 52. 1982. JAMA. 1973. Acta Obstet Gynecol Scand. Pediatrics. Costanza ME. 1984. Wasserman H.18:9 –15 8. Nicotine and cotinine concentrations in the milk of smoking mothers: influence of cigarette consumption and diurnal variation. 1998. 1977. The excretion of radiopharmaceuticals in human breast milk: additional data and dosimetry. et al. Gilcher RO. Committee on Drugs. Squires L. Levine JJ. Nau H. 2000
26.27:1569 –1571 41. Hopkinson JM. 1979. Bachur NR.271: 213–216 18. Karjalainen P. Marcoux S. Kjellmer I. The effect of maternal narcotic addiction on the newborn infant: review of literature and report of 22 cases. Worthington-Roberts B. Breast milk contamination and silicone implants: preliminary results using silicon as a proxy measurement for silicone. Am J Epidemiol. Rutherford LD. J Nucl Med. Eur J Nucl Med. Pediatrics. Rockville. 1952. Rose MR. 83:93–97 10. Bisdom W. USP DI 2001: Information for the Health Care Professional. Pittard WB III. Hoops EC.92:163–167 20. Semple JL. Tobin RE. Abreau CM. Trachtman H. Herman KJ. Nurnberger CE. Kereiakes JC. McArdle HJ. Robinson PS. Klopper J. Frisenette-Fich C. Br J Clin Pharmacol.130:837– 839 6. The presence of cyclosporine in body tissue and fluids during pregnancy. 1969. 1971. Duncan JH.102:1112–1115 22. Eur J Pediatr. Radioactive iodine uptake by thyroid of breast-fed infants after maternal blood-volume measurements.
1. Presence of delta9-tetrahydrocannabinol in human milk. Danks DM. Proc Soc Exp Biol Med. Plast Reconstr Surg. Schneider PB.147:117–126 15. Luck W. 1943. The transfer of drugs and other chemicals into human breast milk. Vogel CL. Excretion of 125I in breast milk following administration of labelled fibrinogen.49:377–379 51. Nicotine and cotinine concentrations in serum and urine of infants exposed via passive smoking or milk from smoking mothers. Rubow S. Luck W. Cocaine intoxication in a breast-fed infant.21:144 –153 49. Woodward A. 1985. 1998. Montvale.81:550 –557 12.24:288 –304 35. Amato D. J Pediatr.102: 528 –533 23.17:1055–1056 39. 1991. Hood RT Jr. Pediatrics. O’Connell ME.41: 1600 –1603 19. PCP in amniotic fluid and breast milk: case report.70:231–234 55. Henson P. Gold DM. Iodine-131 in breast milk following therapy for thyroid carcinoma. Pharmacokinet-
AMERICAN ACADEMY OF PEDIATRICS
. Weber JP. 1989. Niblett JS. Lane TH. 1986. American Academy of Pediatrics.44:269 –270 37.5:60 – 63 29. J Nucl Med. Egorin MJ. Braverman LE. Nau H. Milk production by mothers of premature infants: influence of cigarette smoking. Abt S. 1983. Penttila IM. 1990. Am J Obstet Gynecol. Lugowski SJ. Kjoller K. Egan PC. 1983.52:672– 673 43. Englewood. Nau H. Lancet. 1993. Pediatrics. Health outcomes in offspring of mothers with breast implants. Physicians’ Desk Reference. 1998. Barker P. Radiation dose to breast-feeding. 1994. Young PR. 2001 24. Volume I. Secretion of radio-active sodium in human milk. Determination of nicotine concentrations in human milk. Clin Sci. Br J Radiol. Excretion of radioactivity in breast milk following 99Tcm-Sn polyphosphate. 1985. Mclaughlin JK. Fraley JK. Nau H. J Nucl Med. US Pharmacopeia. Douglas RM. Friis S. J Nucl Med. Dodion P. LeVier RR. Baard B. Berlin CM Jr. Schulte-Hobein B. Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking. van Niekerk M. Eur J Clin Pharmacol. J Nucl Med. 1959. Cancer Treat Rep. 1994. Dig Dis Sci. Silicone breast implants and breast-feeding.35:1797–1801 48.90:934 –938 13. and cotinine concentrations in mother’s milk and infant’s urine. 1987.50:357–361 45. lactation period. 1987. 1982. Miles H. 1971. JAMA. Chusid E.35:73– 81 11. Nau H. 1989. Maternal smoking during lactation: relation to infant size at one year of age. Radiation dosimetry from breast milk excretion of radioiodine and pertechnetate.2:1039 –1041 46.72: 375–383 2. renography and placental localization by 131 I labelled tracers. Szaz KF. and manuscript preparation. Rogers AJ. Keen RL. J Nucl Med. Chasnoff IJ. Fletcher BD. and technetium-99 m-macroaggregated albumin into breast milk. Baines CJ. Pystynen P. Uptake of 67Ga in the lactating breast and its persistence in milk: case report. Prescott MC. Wiernik PH. Wilson DJ. Plum C. Petrucha RA. Am J Dis Child. 1976. Smith DC. Nicotine and cotinine concentrations in serum and milk of nursing mothers. JAMA. Transmission of radioiodine (I131) to infants through human maternal milk. Half lives of nicotine in milk of smoking mothers: implications for nursing. Toxicol Lett. Garza C. Steldinger R. Little RE. 1992. Hahn PF. J Trace Elem Exp Med. Ilowite NT. Pediatrics.84: 924 –936 3. 1994. Pediatrics. McNamara PJ. Honour AJ. Committee on Drugs. Wyburn JR.1:383–384 28. 2001 25.59:80 40. Johns DG. Zaadstra BM. 1990.69:241–244 57. Hallberg M.4:81– 84 38.12:188 53. Wright CE.27:123–124 33. Radioactive excretion in human milk following administration of technetium Tc 99 m macroaggregated albumin. Amphetamine secretion in breast milk. Pediatrics. Leighton PC. Wall ME. Surveyor I. Esophageal dysmotility in children breast-fed by mothers with silicone breast implants: longterm follow-up and response to treatment. Ervin CH. Boshuizen HC. document retrieval. Pettei MJ. Pediatrics. Secretion of copper 64 into breast milk following intravenous injection in a human subject. 1971. 1996. Farr RF. Secretion of radioiodine in digestive juices and milk in man.52:223–224 50. Merkatz R.31:978 –984 42. Kuhn RJ. Smoking and passive smoking during pregnancy and early infancy: effects on birth weight. Saenger EL. Harrison MC.ACKNOWLEDGMENT
The Committee on Drugs would like to thank Linda Watson for her work in reference identification. Committee on Drugs. Breast-feeding during treatment with cyclosporine. Ferron L. Palmer KE. Transfer of drugs and other chemicals into human milk. CO: Micromedex. 109:178 5.107:816 – 820 9. Lewis DE. Lambert MD III. Verloove-Vanhorick SP. Vagenakis AG. J Epidemiol Community Health.93:137–150 4. Cook RR. American Academy of Pediatrics. Cyclophosphamide in human milk. Pediatrics. Nau H. US Pharmacopeia. Nyberg G. Cobrinik RW. Doxorubicin and cisplatin excretion into human milk. Hutchinson TA. The amount and form of radioactivity in human milk after lung scanning.1:912 27. Levine JJ. Herngreen WP. Fabia J. Abt S. Haljamae.307:819 – 820 36. Sclerodermalike esophageal disease in children breast-fed by mothers with silicone breast implants. Docker MF. J Nucl Med. Butt D. Bland EP.80:836 – 838 34. Maternal smoking during lactation: relation to growth during the first year of life in a Dutch birth cohort. Br J Radiol. 1986. Berke RA. Reerink JD. Rane A. Indium-111 radioactivity in breast milk.140:544 –554 14. J Perinat Med.16:261–262 16. 1982. Labrecque M.69: 1387–1389 31. 1985. Steiner E. Excretion of iodine-123-hippuran. Secretion of methotrexate into human milk. 1994. Schwartz-Bickenbach D.44:224 –230 17. Am J Kidney Dis. J Clin Psychiatry. Schwartz-Bickenbach D. N Engl J Med. Rowlands EN. Desai N. NJ: Medical Economics Company.150:1398 –1400 47.11:447– 462 44. 1984. American Academy of Pediatrics. 1994. Pediatrics. Lancet. Cigarette smoke exposure and development of infants throughout the first year of life: influence of passive smoking and nursing on cotinine levels in breast milk and infant’s urine. Med J Aust. Schanler RJ.146:21–26 7. American Academy of Pediatrics. Psychotropic drugs in pregnancy and lactation. Flechner SM. Schaffner W. Di Simone RN. Lipscomb A. 1976. Verkerk PH.112:978 –980 32. 1952. What is silicone? Plast Reconstr Surg. MD: US Pharmacopeia. Oo CY. Katz AR. Sutton H. Luck W. 1972. 1983. Pitts FN Jr. Feeding and urine cotinine values in babies whose mothers smoke. Kahan BD. 1992. 1976. Myant NB. Transfer of drugs and other chemicals into human milk. ed. Campbell A. Kaufman KR. 1937. Crawford JS. technetium-99 m-red blood cells.65:253–255 30.94:547–549 21. Pediatrics. Duration of radioactivity in the milk of a nursing mother following 99 mTc administration.
Craggs M. 60. Chloramphenicol (Chloromycetin) in the treatment of tsutsugamushi disease (scrub typhus). Ananth J. Hall RW. 1968. Gupta AP. Branebjerg PE. Lancet. Kauppila A. Nelis GF. J Clin Endocrinol Metab. Clin Pediatr (Phila). Plomp TA.24:269 –272 112. Fluoxetine in breast-milk and developmental outcome of breast-fed infants.167:635– 636 Briggs GG. Shaag Y. McDougle CJ. Sertraline and desmethylsertraline in human breast milk and nursing infants. Morselli PL. Accumulation of atenolol and metoprolol in human breast milk. Popov V.137:855– 856 Erickson SH. 1990. 71. Smith B. Paroxetine in human breast milk and nursing infants. Eur J Obstet Gynecol Reprod Biol. 5-Aminosalicylic acid its metabolite in breast milk during lactation [letter]. Sertraline and breastfeeding.50:741–742 Dusci LJ. Br J Clin Pharmacol. Wilschanski MA. Clin Pediatr (Phila). 1980. 73. 69. 1996. 1978. Taylor T.342:618 – 619 120.137:849 – 850 102. Effects of chlorpromazine on pituitary function. Br J Clin Pharmacol. Excretion of trazodone in breast milk.614:328 –332 99. Possible association between fluoxetine hydrochloride and colic in an infant. Excretion of clofazimine in human milk in leprosy patients. Schimmel MS. Tomson T. Obstet Gynecol. Br Med J (Clin Res Ed). Saria A. 83. Karas B. Excretion of fluoxetine in human breast milk. Woodward TE. Br J Clin Pharmacol. 1993. 70. Excretion of fluvoxamine in breast milk. et al. Ambrose PJ. The excretion of dothiepin and its primary metabolites in breast milk. Am J Gastroenterol.
88. 1991. Koren G.81:947–949 104. Boutroy MJ. Milsom I. Epperson CN. Ley HL Jr. Smith GH. Excretion of iohexol and metrizoate in human breast milk. 2000. Evaldson GR.19:503–507 116.28:81–91 105.154:1255–1260 94. 59. Pediatrics.29:123–126 Borgatta L. Yoshida K. Diarrhoea due to 5-aminosalicylic acid in breast milk. Ashford JJ. Nielson MS. Pelkonen O. Ilett KF. Weight gain in infants breastfed by mothers who take fluoxetine. et al. 1999.148:1234 –1236 90. J Clin Invest. Booth J. Clinical significance of methohexital. Shimoyama R.37:186 –192 Dencker SJ. Orsulak PJ. Bredesen JE. Yapp P. and breast milk. Venkatesan K. J Chromatogr. 1972. Vitols S. Single case stuy.
67. 1981. Br J Clin Pharmacol. Erickson SH. 1994. Weber P. 1997.24:457– 462 Lebedevs TH. 1990.
61. 82. Ohkubo T. Eidelman AI. 1985.1:383 118. 1986. Am J Psychiatry. The safety of fluoxetine during pregnancy and lactation. Nortriptyline treatment of breast-feeding women. Andreozzi L. McKenna EA. Johansson G. Metoclopramide as a lactogogue. Stowe ZN. 1991. 1992. Kumar RC. 1949. Epilepsia. Reavey P. 1997. Am J Psychiatry. Ilett KF. de Vijlder JJ. Wojnar-Horton RE. Ito S.22:367–370 95. Cohen LS.151:945 101. Viktorinova D. Negligible excretion of 5-aminosalicylic acid in breast milk. Teratology. Am J Psychiatry. Kumar RC. Owens MJ. Lunde PK.85:331 119. 84. 1998. Clin Toxicol. Anderson PO.89:676 – 677 Taddio A. 1956. meperidine. Lancet. Nemeroff CB. Sugawara K.53:304 –308 Yoshida K.107:69 –72 Summerfield RJ.27:431– 433 Schimmell MS. Pastuszak A. J Clin Pharmacol.89:676 – 677 Lester BM. Metoclopramide and breast feeding: transfer into milk and the newborn. Newman K. Ohkubo T. Liedholm H.2:59 – 68 Hilbert JM. Br J Clin Pharmacol. et al. Psychol Med. 85. Smith B. Syversen G. Wisner KL. Bitzen PO. Schroeder DH. Use of amiodarone during pregnancy. Tilstone WJH. Gural RP. 1998.
63. 1996. Eur J Clin Pharmacol. et al. Vulsma T. Klotz U. Oppenheim GL.51:169 Nulman I. Hackett LP.28:523–526 98. Ogilvie RJ.43:201–207 107. 86. Concentrations of N-descyclopropylmethylprazepam in whole-blood. Haloperidol secreted in breast milk. 1985.
78. J Perinat Med. Anderson GM. Polishuk WZ. Shimoyama R. 64. 1984. 1992. 1976. 1996. Girdhar BK. a new antidepressant. Serum and breast-milk concentrations of dothiepin [letter]. Gruss L. Koivisto M. Diazepam and active metabolite in breast milk and their transfer to the neonate. 1986. Acta Radiol. 1998. Bartels U. Lepr Rev. and milk after administration of prazepam to humans. Landry JC. J Pharm Sci. Am J Psychiatry. Pediatrics. 1983. Tricyclics and breast feeding.29:479 – 484 Sovner R. Mathur A.153:295 91. 68. Stewart RB. et al. Nielsen ST. Arch Dis Child.32:1253–1255 Burch KJ. Toxic neonatal effects following maternal clomipramine therapy. Shaw D Jr. Br J Clin Pharmacol. Orr MW.143:1597–1600 Rees JA. 1986.
74. Bianchetti G. Amoxapine. Br J Clin Pharmacol. Prime JK. 75. Sporne GA. Hailey DM.pediatrics. Verbeeck RK. 1981.136:451– 452 Stancer HC. Quantification of naturally occurring benzodiazepine-like substances in human breast milk. Am J Psychiatry. Br J Clin Pharmacol. 1985. Heidrich F. Am J Psychiatry.336:1189 –1190 93.
76. Harings-Kaim A. 1997. Blain PG.104(5).33:204 –206 Bader TF. 1981. Lindgren S. Perel JM.30:737–739 117. Excretion of bupropion in breast milk. Samson JH.13:204 –211 108. Smith GH. and diazepam in breast milk. Ohman I. Wiles DH. Vert P. Kivinen S. Lancet. Stowe ZN. 1983. 1990. Accessed December 20. Koren G.
81.25:819 – 823 113. Barnas C. Desipramine and 2-hydroxydesipramine in human breast milk and the nursery infant’s serum. Craggs M. Eur J Clin Pharmacol. Hummer M. Owens MJ.31:209
62. Rane AT. Rasmussen JN. Dubruc C. Wojnar-Horton RE. Nord CE.57:48 –50 114. Blood and milk concentrations of metronidazole in mothers and infants. amniotic fluid. Smadel JE. Measurement of haloperidol in human breast milk by high-performance liquid chromatography. Jenss H.1:542–543 Cole AP. Wisner KL. Kolakowska T. 72. appears in human milk. Jenny RW. Ong C. Katz EZ.135:801– 805 106.136:1483–1484 Gelenberg AJ. Pediatrics.36:42– 47 Brent NB.157:185–189 92. 1978. Side effects in the neonate from psychotropic agents excreted through breast-feeding. Andrew E. 1997.
79. Hostetter A. Psychopharmacology (Berl). plasma. 1990. in human breast milk. Tinidazole milk excretion and pharmacokinetics in lactating women. Chlorpromazine levels in plasma and milk of nursing mothers. 1987. Evang A. 1997. Metronidazole in breast milk. J Clin Pharmacol. Br J Clin Pharmacol. Wells BG. 1993. Dawling S. Excretion of doxepin and N-desmethyldoxepin in human milk.40:231–236 Patrick MJ. Zampaglione N. 1979. N Engl J Med. Good SM.68:242–246 110. 1992. Hartmann F. Eur J Clin Pharmacol. Lebedevs TH. 2000 Wright S. Excretion of imipramine and desipramine in human breast milk. Diazepam and breast-feeding. 1975. Hejzlar M. Excretion of lorazepam into breast milk. Reed KL. Biopharm Drug Dispos. Whalley LJ. 66.172:175–178 Chambers CD.
THE TRANSFER OF DRUGS AND OTHER CHEMICALS INTO HUMAN MILK
. 1993. 1979. Ann Pharmacother. Excretion of diazepam and its metabolites in human milk during withdrawal from combination high dose diazepam and oxazepam. Clozapine concentrations in maternal and fetal plasma. Sugawara K. Am J Psychiatry.16:292 96. Br J Psychiatry. Perel JM.20: 497– 499 Burch KJ. Hafsahl G. Thomas RG. J Clin Psychiatry. Bergant A. Available at: http://www.30:787–793 Olesen OV.282:1746 –1747 103. norfluoxetine. Koren G. 1992. Overo KF. Wisner KL. Glass RC.57:1042–1043 Matheson I. Practitioner. 1989. Fluoxetine/norfluoxetine concentrations in human milk. Symchowicz S. Lamotrigine in pregnancy and lactation: a case report. 1984. Haloperidol excretion in human milk. Matheson I. Serum nortriptyline levels in nursing mothers and their infants.org/cgi/content/full/104/5/ e61. Excretion of chloramphenicol in human milk. Gupta PK. Fluoxetine and carbamazepine concentrations in a nursing mother/infant pair.11:114 –120 115.217:686 Ilett KF.33:635– 639 Kemp J. Heisterberg L. Am J Psychiatry. Excretion of fluoxetine and its metabolite. Ritchie JC. Wells BG. Excretion of temazepam in breast milk. Poulsen JH. Fluoxetine/norfluoxetine concentrations in human milk. 77. 1992. Perphenazine in breast milk and serum. Am J Psychiatry. Br J Clin Pharmacol. Amitriptyline in human breast milk and the nursing infant’s serum. Oh W. Havelka J. 1992. Presence of chlorprothixene and its metabolites in breast milk. 1981.
ics in lactating women: prediction of alprazolam transfer into milk. Determination of chlorpromazine in human breast milk and serum by high-performance liquid chromatography. 1993. Arvela P.147:1378 –1379 Brodie RR.58. Ylikorkala O. 80. 1991. 27:611– 613 100. Fleischhacker WW. Am J Psychiatry. J Am Acad Child Adolesc Psychiatry. Excretion of quazepam into human breast milk. Matheson I. J Clin Pharmacol. Prochazka J.20: 229 –231 121. Ross SG. Melander A. 1979. Flanagan P. Midazolam and nitrazepam in the maternity ward: milk concentrations and clinical effects. Chemotherapy. Br J Anaesth. Am J Psychiatry. 1985. Cucca J. Springer PK. Chasseaud LF.37:41– 44 Isenberg KE. Kulcsar SA. 1992. Barad D. 1990.28:1196 109. 1995. Am J Psychiatry. et al.38:1039 –1041 111. Girdhar A.5:272–273 97. 1980. J Nerv Ment Dis. Neuroleptic drugs in breast milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Skinnemoen K. To nurse when receiving acebutolol: is it dangerous for the neonate? Eur J Clin Pharmacol.
Kerem E. 147. Antithyroid drugs: to breast-feed or not to breast-feed. tissue concentrations in foetus and newborn. 1985. Clin Pediatr (Phila). II. Koch S. Wahlin-Boll E.157:234 –235 Lamberg BA. Swahn CG. Jager E. J Pediatr. Br Med J. 1947.157:275 Schou M. N Engl J Med. Arch Gynecol. Kanto J. 151.
133. Dubois M. Acyclovir in human breast milk. Fleiss PM.158:586 –588 Binkiewicz A. Scand J Clin Lab Invest. Passage of cephalosporins and amoxicillin into the breast milk.2:1299 Eckstein HB. 1984. Concentrations of baclofen in serum and breast milk from a lactating woman. 3. Placental transfer and pharmacokinetics of primidone and its metabolites phenobarbital. 1985. Kirksey A.
126. Basic and Therapeutic Aspects of Perinatal Pharmacology. 1990. Wilson WG. 1975:319 Jamali F. Excretion of paracetamol in human breast milk. 168.4:299 –301 Kulas J. Excretion of drugs in human milk: review. 134.
144. Hertz CG. Influence of vitamin B6 intake on the content of the vitamin in human milk. Primidone and phenobarbital during lactation period in epileptic women: total and free drug serum levels in the nursed infants and their effects on neonatal behavior. Lambotte R. Hirsch M.2:272–273 Branski D. Wong SH. Drugs transmitted through breast milk. Carbamazepine: placental transport. Effects of bromocriptine mesylate on the composition of the mammary secretion in non-breastfeeding women. A comparison of their excretion into human breast milk. 175.
169. Caffeine in human milk and in serum of breast-fed infants. Hunter RE. Lithium carbonate and breastfeeding. Obstet Gynecol.3:237–244 Berlin CM Jr. 1976.
177. J Pediatr Gastroenterol Nutr. Drowsiness due to clemastine transmitted in breast milk. 1983. Acta Derm Venereol. 163.63:42S– 44S Kulski JK. 154. 1981. 183. Barbiturates. Kroll D. 132. Clin Pharmacol Ther. Captopril in human blood and breast milk. Denson HM. Egger JH. McClelland DB.71:161–164 Kafetzis DA. Andreoli JW. J Obstet Gynaecol Br Emp. 174. DeAngelis RL. Eur J Clin Pharmacol. Maternal alcohol use during breast-feeding and infant mental and motor development at one year. Human perinatal distribution of butorphanol. 146. Kearney MF. 135. 1979. Melander A. Analgesic drugs in breast milk and plasma. saliva. 1980. Semin Perinatol. Clayden G. Rane A. 1988.
blood of lactating women after ethanol administration. Yaffe SJ. Nau H. Abrahamov A. Eakin R. Takimoto M.70:487– 490 Lau RJ. Acetazolamide excretion into human breast milk. Ward RM. 21:81– 87 Tyson RM.
160. 1984. Disposition of dietary caffeine in milk.
178.1:672– 673 Nau H.118:65– 69 White WB. Frantz M. Antithyroid treatment of maternal hyperthyroidism during lactation. Dangers of vitamin B6 in nursing mothers.54:426 – 431 Bald R. Martin JD. J Pediatr. J Obstet Gynaecol Br Emp. Eur J Clin Pharmacol. PEMA and hydroxyphenobarbital in neonates and infants of epileptic mothers. Transfer of carbetocin into human breast milk. Int J Pharm. Rosing U. Atenolol in human plasma and breast milk.17:599 – 600 Rollman O. J Obstet Gynaecol Br Commonw. Georgakopoulos PA. Clin Pharmacokinet.
129. maternal and neonatal pharmacokinetics. and plasma of lactating women.321:425– 430 Kamilli I. levels of the vitamin in biological fluids. Atenolol and metoprolol. Eur J Clin Pharmacol.54:787– 800 Hildebrandt R. 141.
159. Papadatos CJ.
155. Shrader EA. Pseudo-Cushing syndrome caused by alcohol in breast milk. 156. Acta Paediatr Scand.21:110 –113 Nau H. 1972. 1985. 1983. 1982. stroke. 1989. Dev Pharmacol Ther. Gresser U. Senior B.114:476 – 478 Thorley KJ.20:123–125 Findlay JW. Stern M. 150.13:86 –90 Knott C. Quantitation of the vitamin and its binder and the uptake of bound vitamin B12 by intestinal bacteria. Clin Investig.59:1153 Tyson RM. 140. 1961. 179. Breast-feeding and anticoagulant therapy. 1987. 1982.13:91–93 Pittman KA. Lorber J. J Pediatr.8:355–363 Devlin RG. Ervin CH. Steen B. Koch S. Ikonen E. Clin Endocrinol (Oxf). Ethanol and acetaldehyde in the milk and peripheral
152. 1974. Welch RM. Bloody diarrhea—a possible complication of sulfasalazine transferred through human breast milk. 166. Excretion of azpropazone in human breast milk. Infantile spasms on weaning from breast milk containing anticonvulsants. Lithium ingestion by children breast-fed by women on lithium treatment. Richwald GA. 1980. Acta Pharmacol Toxicol (Copenh). Helge H. Trans R Soc Trop Med Hyg.
139. Horbay GL.66:822– 824 Clark JH.1:135–141 Bitzen PO.
127. In: Marselli PL. Vitamin B6 nutriture during pregnancy lactation.5:316 –317 Berlin CM Jr. de Miranda P. Allopurinol and oxypurinol in human breast milk. Bernbeck-Betthauser EM. Reynolds F. Am J Obstet Gynecol. Gross-Kieselstein E.70:285–288 Berman JD. Transplacental.8:329 –337 Ryu JE. 1980.
143. 176.11:824 – 832 Yoshioka H. Smith M. Gundert-Remy U. Obstet Gynecol. Drugs transmitted through breast milk. condition of the infant at birth. Shrader EA. Sunshine A. The effect of thiamin and riboflavin supplementation on the level of those vitamins in human breast milk and urine. saliva.
124. Effect of dicumarol on the nursing infant. N Engl J Med.300:141–142 Samson RR. J Pediatr. McAinsh J. and seizures after suppression of lactation with bromocriptine.2: 138 Tunnessen WW Jr. Am J Clin Nutr. Toxic effects of atenolol consumed during breast feeding. 1973. 1954. and level in milk.122. 1978. 1970. Lancet. J Pediatr. Hartmann PE. Maruyama S.81:804 – 807 Sykes PA. 1984. 1988. Acta Obstet Gynecol Scand Suppl.
Koren G. 157.
158. and plasma of lactating women. 1981.33:198 –204 Roepke JL. 1981. Dodson WE. Pihl-Lundin I. J Pediatr.41:244 –253 Silcox J. 1981.20:53–54 Levy G. Acitretin excretion into human breast milk. Galinsky RE. Melby PC. 1989.19:509 –511 Nail PA. Pediatr Pharmacol (New York). 1979. 1937. Disposition of acetaminophen in milk. Am J Obstet Gynecol. 1977. Hartvig P. Worthington-Roberts B. Drugs transmitted through breast milk. Obstet Gynecol. III. Osimoni A.32:2249 –2256 West KD. Acta Paediatr Scand. 1978. 131. Zighelboim I. Arch Dis Child. 1979. Sheth N. Osterlund K. Toxic effects of lithium in newborn infants: a commentary. Obstet Gynecol. Kramp R. Bromides. 1986. Concentration of Pentostam in human breast milk. 167. Bennett MJ.
137. J Clin Pharmacol. Helge H. I. Cho K. Br J Clin Pharmacol. Obstet Gynecol.7:508 –543 Pynnonen S. A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Quarrie J. 29:625– 633 Soderman P. Puerperal hypertension. Ragni M. Lancet. Robinson MJ. 1950. Vitamin B6 intake. 1993. 1976. Smyth RD. Pediatr Pharmacol (New York). 130. Spahn H. Lancet. 1981. 165. Perlman HH. 182. Delapierre D. 136. Caffeine secretion into breast milk. Spruance S. Taitz LS. 149.
173. Methaemoglobinaemia in newborn probably due to phenytoin excreted in human milk. Findlay JM. Cohn RD. Jostell KG. Mutschler E.69:468 – 471 Meyer LJ. Am J Obstet Gynecol. Br Med J. Anderson KW. 180. 1985.
142.73:59 – 63 Ryu JE. Am J Obstet Gynecol. 1979. Alexander FW. J Pediatr. I. Untersuchungen uber den Ubergang des aktiven agens des Mutterkorns in die milch stillender Mutter. Shrader EA. 1981. Neva FA. Siafas CA. 171. Anticonvulsants during pregnancy and lactation.
138. New York. 170. Helge H. ed. Br J Clin Pharmacol. Lunell NO. Salicylate pharmacokinetics in the human neonate. Aztreonam in human serum and breast milk.
181.138:797– 800 Berlin CM Jr. Maduska AL. et al. Schulz P. Am J Obstet Gynecol.
153. 1989. Unexpected accumulation of acyclovir in breast milk with estimation of infant exposure.69: 93–99 Eriksson G. Dev Pharmacol Ther.81:84 – 86 Little RE. Thomas MR. Sillanpaa M.11:147–154 Finch E. 1934.18:31– 42 Kuhnz W. Holt DW. 1980. Rating D. 1984. Wassenaar W. Keshavarz E. Hurvitz H. Kuhnz W. Gordon J.8:285–290 Kok TH. 125.82:456 – 459 Cooper DS. Transfer of cefazolin into human milk. Litt R. 1938. Effect of maternal caffeine consumption on heart rate and sleep time of breast-fed infants. Levels of the beta-blockers atenolol and propanolol in the breast milk of women treated for hypertension in pregnancy. Salicylate excretion in breast milk. Losada M.
161. 1980. 1990. Am J Clin Nutr. 1973.
148. Shimizu T. Hauser I. Perlman HH. Effect of different doses of ethanol on the milk-ejecting reflex in lactating women. Lithium and pregnancy. Clarren SK. Gustafsson B. 162. 1984. Fagerlund C. 1987. Excretion of the methylxanthines in human milk. Perlman HH. 1981. 1987. Pediatrics. Amdisen A.41:185–187 Healy M.
164. Jack B. Biopharm Drug Dispos. Rating D.5:389 –394 Tyrala EE. 1993.61: 833– 834 Tyson RM. Erkkola R.83:784 –785 Sapeika N. Pak I. Lack of pharmacological active saliva levels of caffeine in breast-fed infants.
123. 1938.93:965–967 Cobo E.115:817– 821 Kesaniemi YA.1:1353 Brambel CE. Am J Clin Nutr. Daniel CH. Emery MG. 1981. Kirksey A. Suppressing lactaton with oral diuretics.29:961–969 Greentree LB. Transmam-
AMERICAN ACADEMY OF PEDIATRICS
.52:38 – 42 Katz M. Laxatives.94:151–152 Dresse A.39: 271–273 Fleiss PM. NY: Raven Press. Vitamin B12 in human colostrum and milk. Lancet. Devlin RG. Dev Pharmacol Ther.1:914 –915 Fomina PI.
mary passage of cefoxitin: additional results. Curr Ther Res Clin Exp.132:653– 657 233. Rothberg AD. J Hum Lact. Contraception. Clin Pharmacol Ther.19:475– 482 Snider DE Jr. Miller AM. Fernandez H. 1973. Gabbe SG. 212.
192. Hoppu K. 1984. dapsone and pyrimethamine in human milk. Lucas BD Jr. Ethosuximide pharmacokinetics in a pregnant patient and her newborn. Sandholm LE. Demir N.60:780 –781 221. 185. Okada M. Portmann R. Force RW. 1979. Br J Clin Pharmacol. Biddle CJ. J Magn Reson Imaging. Hollis BW. 1995. Aigrain EJ. Excretion of diltiazem in human milk [letter]. Napoli JL. Malesic I. The effect of oral contraceptives on concentration of various components of human milk. Greenhalf JO. 188. Celiloglu M.48:262–267 237. Parr GD. Digoxin excretion in human breast milk.9:19 Ogunbona FA. Contraception. Am J Med Sci. 1982. Kinkel AW. 1979. Darbois Y. Eur J Clin Pharmacol.210:259 –263 219. 1986. 196. Colchicine in breast milk of patients with familial Mediterranean fever. Inoue H. Pharmacokinetics of three newer quinolones in pregnant and lactating women. Nygren KG. J Reprod Fertil. Nakamura Y. Aspects of folate metabolism in lactating women studied after ingestion of 14C-methylfolate. Br J Clin Pharmacol. 1990. Bolaji OO. Wagner X. Aguilera E. 1984. 1995.23:295–296 Kora SJ. Dreisbach JA. Valentin J.33:203–213 Meny RG. Oelofse R. Mellbin T. Powell KE. Res Reprod. 1992. Jorboe CH.
202. Sfikakis P. Arthritis Rheum.57:398 – 402 236. Levy M. 208. Alger LS. Zylber-Katz E.19:1374 246. Assenzo JR. Ross FP. 1986. Transfer of contraceptive steroids to human milk.23: 438 – 440 Shyu WC. Owen JP. 197. Lantz RK. 1976. Zakut H. Retief FP. Neuvonen PJ. Kishimoto M.16:777–778 247.297:789 224. 203. Br Med J. Mayer PR. Levy M. 1978. Jouglard J. Harter C. Sonnendecker EW. Arthritis Rheum. 1994. Secretion of the gastrokinetic agent cisapride in human milk. Binet MH. Lancet. Contraception. Moulin M. Nygren KG.36:938 –941 Blanco JD.184. Fertil Steril. Long-term follow-up of children breast-fed by mothers using oral contraceptives. 1991.61:177–178 Nilsson S. Veenendaal JR. Heyns AD. Torimiro SE. Kuhn RJ. Koup JR. Rose JQ.23:473– 476 Edstein MD.
205. Rofsky NM.5:57– 60 232.23: 479 – 480 Bourget P. Sulphone levels in breast milk of mothers on sulphone therapy. Linder N. Granit L. Hofmeyr GJ. Paulini E. Steer PL. Eaton CJ. Burghart PH.30: 359 –361 226. N Engl J Med. Biol Res Pregnancy Perinatol. Mattern J. Pediatr Infect Dis J. 1983. 1908. Am J Med. Quantitative analysis of gadopentetate dimeglumine excreted in breast milk. 1986. Fertil Steril. Aravantinos D. Jorgensen JH. Litt AW. J Pediatr.
198.4:684 Reed CB. 1979. Hilleman DE.19:535–539 234. McNamara PJ.22:39 – 41 Curtis EM. 1985. Pisapia A. 1986. 1964. Oral-contraceptive feminization of a normal male infant: report of a case. Levy M. Cohn RD. Schwartz A. 1990. 204. Excretion of chlorothiazide in human breast milk. 1969. High concentrations of vitamin D2 in human milk associated with pharmacologic doses of vitamin D2. Antimicrob Agents Chemother.
210. A study of the conditions that require the removal of the child from the breast.277:281–288 243. Br J Radiol. Flecainide excretion in human breast milk. Cohen ME. Effects of oestrogen and progestagen on the composition of human milk.81:781–783 Miller EM. Excretion of chloroquine and desethylchloroquine in human milk. 1981. Am Heart J.20: 419 – 423 Toaff R.112:806 Zacharias S. Cook LN. Bell RA. Nygren KG. Maternal-infant vitamin D relationships during breast-feeding.13:129 –131 Somogyi A. Excretion of drugs in human milk. Loughnan PM. Obstet Gynecol. Arthritis Rheum. van Reenen OR. Oosthuizen M. Crawford SA. 1986. Clin Pharmacol Ther. J Pediatr. 1982.39: 1213–1217 Guillonneau M. 1986. Castaneda YS. Disopyramide and breast feeding [letter]. Greer FR. 209. 1969. Concentration of fentanyl in colostrum after an analgesic dose. Cohen DF. de pacientes sob regime do sal loroquinado. 1990. Desai N. 1975. Pisani A. Ann Pharmacother. 1957. Quinquis-Desmaris V.68:138 –140 Barsivala VM. Excretion of fluorescein into breast milk.
199. Effect of oral contraceptives on lactation. Buchanan N.
186. 1983.7: 307–312 Borglin NE. McQuinn RL. 1969. Kolokythas E. Petrikkos G. J Endocrinol. Clin Pharmacol Ther. Antimicrob Agents Chemother. Brill-Miller JL. 1971.119:700 –702 238. 1995. Granit L.11:1–2 American Academy of Pediatrics. Pau WK.
195. Clindamycin in human breast milk [letter]. Drug toxicity from breast milk [letter]? Pediatrics.
190. Antimicrob Agents Chemother. Effects of hormonal and nonhormonal contraceptives on lactation and incidence of pregnancy.1:647 229. Koeff ST. Newman K.144:589 –590
215. Johansson ED. Active transport of cimetidine into human milk. Laufer N. 1952. J Pediatr. Penetration of fleroxacin into breast milk and pharmacokinetics in lactating women.30:735–736 Smith JA. Miravet L. Br J Clin Pharmacol. 1996.101:789 –791 Mulley BA. Pereira JP. The breast milk excretion of flufenamic acid.34:443– 457 Nilsson S. Dyphylline elimination kinetics in lactating women: blood to milk transfer.22:733–735 Werthmann MW Jr. Letter: metabolism of gold during lactation. Shah VR. Tuncok Y. 1995. 1977.38:99 231. Wafa S. Am J Ophthalmol. Rachlis AR. J Pediatr.
187. Excretion of dipyrone metabolites in human breast milk.7:627– 629 Oo CY. Arthritis Rheum. Should women taking antituberculosis drugs breast-feed? Arch Intern Med. 1993. Petitjean J. Eur J Clin Pharmacol. Leonard HS. Eur J Clin Pharmacol. Williams DG. Rye RM. Can Med Assoc J. Blau SP.55:603– 605 222. et al.19:856 – 857 227.92:1019 –1020 223. Cancela L. Virkar KD.11:352–354 Giamarellou H. 1989. 1986. Purdy CY. Hyslop R. Gentamicin excretion and uptake from breast milk by nursing infants.109:598 –599 242. Weinreb JC. Obstet Gynecol. 1981. Mould JJ. 1982. Kelly JG. Lepr Rev. Cooper WD. Excretion of cefprozil into human breast milk.
214. Ceftriaxone distribution and protein binding between maternal blood and milk postpartum. Sundelin C. 189. Le Boulch N. Brown S. 1987. Gugler R. Breast-feeding and contraception.21:405– 410 230. Weidekamm E.39: 231–235 235. Suzuki T. 211. Simultaneous concentrations of ciprofloxacin in breast milk and in serum in mother and breast-fed infant. 1973. N Engl J Med. Hofvander Y. Intravenous urography during lactation. FitzJohn TP. 1978. Epilepsia. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Fluconazole concentrations in breast milk. Eur J Obstet Gynecol Reprod Biol. Buchanan RA. 1984.14:235–236 240. Ceftazidime levels in human breast milk. Scarim SK. Eur J Clin Pharmacol. Rev Bras Malariol Doencas Trop. Redman CW.17:1057
THE TRANSFER OF DRUGS AND OTHER CHEMICALS INTO HUMAN MILK
. Mortimer EA Jr. Sulik PL.87(suppl):49S–51S Hofmeyr GJ. Can J Anaesth. Gold secretion in maternal milk [letter]. 1978.21:553 228. Coadministration of flecainide acetate and sotalol during pregnancy: lack of teratogenic effects. Abel SR. J Pediatr. Hydrochlorothiazide disposition in a mother and her breast-fed infant. 1993. Benjamin S.
191. Matsuda S. Naumburg EG. J Pediatr. et al. Transfer of estradiol to human milk. Siddle NC. Surg Gynecol Obstet. 1993. Nilsson S. Terfenadine pharmacokinetics in breast milk in lactating women. Placental transfer of chlorthalidone and its elimination in maternal milk. Effect of oral contraceptives on lactation. Guven H. Dichloralphenazone and breast milk. Gottlieb NL. Korte T. 1973. 1978. 213. Laker MF. Pettifor JM. 1983. Sagiv R. Da concentracao e eliminacao da cloroquina atraves da circulacao placentaria e do leite materno.312:992–993 225. Am J Obstet Gynecol. 200.3:131–132 244.110:43–50 216.6:514 Soares R. 1993. Br J Clin Pharmacol. passage across the placenta. Herzberg M. 194.27:294 –297 Lacey JH. Colchicine is excreted at high concentrations in human breast milk. Clin Pharm. 1992. Scherrmann J-M. Fleischaker J. 1992. Codeine and the breastfed neonate. Committee on Drugs. Pediatrics. Domperidone and lactation [letter]. Ashkenazi H. Zanartu J. Sonnendecker EW. Erten O.
206. Gazis J. 1974. Galliot M. The excretion of enalapril and enalaprilat in human breast milk. Excretion of chloroquine. Campbell DA.37:293–296 239.101:500 –503 217. Practitioner.105:61– 64 218.9:237–240 Milunsky JM. Krees SV. Br J Clin Pharmacol.58:548 –555 Gardner DK. J Clin Pharmacol. Cimetidine excretion into breast milk. 201. Breast-feeding during colchicine therapy for familial Mediterranean fever [letter]. 1985. Dale IM. Suggested errata. and excretion in human breast milk. Excretion of disopyramide in human breast milk [letter]. Transfer of antibiotics into maternal milk. J Clin Pharmacol. 193.23:101–106 220. Dan M. Onyeji CO.
207. Celiker S. 1977. Papsin FR. Relationship between the vitamin D content of maternal milk and the vitamin D status of nursing women and breast-fed infants. 1972. van Idlekinge B. 1971. 1990.11:533–538 241. Morgan JR. Marley WS.119:164 Ben-Chetrit E.84:263–265 245. MacKintosh D.
The effects of a progestin-only oral contraceptive (levonorgestrel 0. Gillespie WR. Transfer of levonorgestrel (LNG) administered through different drug delivery systems from the maternal circulation into the newborn infant’s circulation via breast milk. 1983. 1981. Am J Obstet Gynecol. 1989. Vandenbergh H. Devlin RG. Witter F. Okonkwo PO. Inturrisi CE. Andreoli JW. Benedetti TJ. 1985. Aarbakke J. 1994. Alpha-methyldopa disposition in mothers with hypertension and in their breast-fed infants. Scott DT. Robieux I. Taylor A. 1967.116:156 271. Brown ND. Excretion of hydroxychloroquine in human milk. Shaaban MM. Drugs can be dangerous during pregnancy and lactations. Savage JM.16:115–120 288.2:691 302. Lebedevs TH. Mexiletine in human blood and breast milk. JAMA. Breast milk magnesium and calcium concentrations following magnesium sulfate treatment. Influence of Norplant levonorgestrel implants upon lactation and infant growth. Radwanski E. Vitamin K-1 content of maternal milk: Influence of the stage of lactation. Ackerman BD. Fischl J. Pediatr Res. Lunell HO. Melander A. Isoniazid and acetylisoniazid disposition in human milk. Aronow R. 1987.36:521–524 269. Donnell D. Vogelhut JW. J Pediatr. et al. Anesthesiology. 1997. McCann MF. Hannon PR. Ilett KF. Olsson B. Dusci LJ. Jerez E. 1996. Varsano I. 1985.37:387–390 291. Morphine excretion in breast milk and resultant exposure of a nursing infant. Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. et al. 1987. Skavdal K.17:910 –911 303. Marcus C.57:546 –547 295. Erickson SH. 1986.102:135 296. 1986. Patel L. Paterson JW. Cholecystography during lactation. Br J Clin Pharmacol. J Pediatr. Shearer M. J Clin Endocrinol Metab. Transfer of interferon alfa into human breast milk. 1986. Sinatra RS.28: 597–599 270.33:357–363 273.23:99 –101 304. 1968. Erickson SH. Ozumba BC. Hackett LP. Eur J Clin Pharmacol. Odlind V.121:617– 621 284. J Pediatr. Ostensen M. J Clin Pharmacol. Wojnar-Horton RE. Nature. 45:305–307 261. Kinkel AW. Thompson JS.42:695– 696 278. Excretion of indomethacin in breast milk.58:823– 826 297. 1990. 1995. Shochet SB. Blinick G. Okonkwo PO.247:463 260. Laumas V. Gaarder TD. Zampaglione N. Reed SB. 1983. Hilbert J. 1985. lipid composition. Br J Anaesth. et al. Robeson P.28:365–370 298. 1981. Ozumba BC.13:227–230 287. Manth SM. Eur J Clin Pharmacol.22:513–517 267. Ito S. 1997. Miller RD. Br J Radiol. Norplant by nursing mothers. 1990. Eur J Clin Pharmacol.28:357 253. Humphries SJ. Betrabet SS. 1979. Herreros C. Lidocaine excretion in breast milk. Valdivieso A.35:477– 486 274. Influence on the prothrombin time of breast-fed newborn babies of one single dose of vitamin K1 or synkavit given to the mother within 2 hours after birth. Paniagua M.149:184 –186 256. Ives TJ. Hofmeyr GJ.35:440 – 444 266. Hanson A. Wittels B.212:924 –925 308.125:135–142 285. Pediatr Res. Eur J Clin Pharmacol. Am J Obstet Gynecol. Zeisler JA. Excretion of metrizamide in milk. Brann J. 1975. Strobel GE. Turner P.73:864 – 869 283. Yapp P. saliva and plasma [abstr]. Fertility regulation in nursing women: VII. Br J Clin Pharmacol. 1985. 1988.32:53–74 272. Hale TW. Fairhead FW. Townsend RJ. Perentesis G. Koeff ST.16:137–142 299. Wahlin-Boll E. Lancet. Blinick G. Liedholm H. Ilett KF. et al. Contraception. 1982. Cooper DS. Moggia AV. Haemolytic anaemia due to nalidixic acid. Drug addiction in pregnancy and the neonate. Ward V. Dyggve HV. J Toxicol Clin Toxicol.82:886 – 887 306. Serwint JR. Azizi F. Drug Intell Clin Pharm. and vitamin K-1 supplements given to the mother. Mexiletine use in pregnancy and lactation. 1978. Spiro TE. 1993.20:691– 693
277. Juez G. 1982. Patel ZM. Albert KS. Eur J Clin Pharmacol. Iodine in mother’s milk [letter]. 2000. Ridgway EC. Buchanan RA. ICMR task force study on hormonal contraception. Goebel U. Diaz S. 1956.143:685 280. Hydroxychloroquine in human breast milk. Acta Obstet Gynecol Scand. Kumar AR. Stevens DR.16:482– 483 255. Jamali F.29: 777–779 250. Methimazole pharmacology in man: studies using or newly developed radioimmunoassay for methimazole. Prenatal and breast milk morphine exposure following maternal intrathecal morphine treatment. Am J Obstet Gynecol. Eaton CJ. Duggan AK. Curr Ther Res Clin Exp. Eur J Clin Pharmacol.44: 543–547 286. Excretion of noscapine in human breast milk. Radioactivity in the breast milk of lactating women after oral administration of 3Hnorethynodrel. Fleiss PM. Mizuta H. Ogbuokiri JE.103:358 292. Drug Intell Clin Pharm. Contraception. J Pediatr. Posey BL. 1982. Trace concentrations of halothane in human breast milk. Excretion of loratadine in human breast milk. Contraception. Varner MW. Nikodem VC. Begg EJ.98:411– 413 307. Townsend RJ.17:468 – 471 276. Westerman RL. Lancet. Berlin CM. DeAngelis C. Bhatnagar S. Hackett LP. Logan B. J Hum Lact.128:855– 858 290.40:635– 648 275. Liu DT. et al. De Mesquita SA.16:226 –228 263. Methadone levels in breast milk. Koren G.31: 251–252 249. Contraception. Cruikshank DP. Becker C. et al. Nadolol in human serum and breast milk. Osborne JP. Effect of methimazole treatment of maternal thyrotoxicosis on thyroid function in breast-feeding infants. 1973. 1992. White WB. Minoxidil in breast milk [letter]. Ivermectin levels in human breast milk.173:1625–1626 268. Layne DS. 1987. McCarthy JJ. Oberlander TF. Lewis AM. Arch Pediatr Adolesc Med. Br J Clin Pharmacol. The influence of medroxyprogesterone on the duration of breast-feeding in mothers in an urban community. Jones RV. Geraghty B. Shore MF. Shikary ZK. Aarbakke J. 1987. 1976. Hulse JD. Fed Proc. Thyroid hormones in human milk and their influence on thyroid function of breast-fed babies.2:576 258.46:89 –90 265. Salem HT. Acta Radiol. Postgrad Med J. 1978. Ivermectin levels in human breast milk. Potts M.114:478 – 480 305. Elwin CE.54:537–538 293. Ichihara K. Sondergaard E. 1991. 1966.30:213–215
AMERICAN ACADEMY OF PEDIATRICS
. Concentration of beta-blocking drugs in human milk [letter]. 1984. Am J Obstet Gynecol. Benedetti T. Terwilliger WG. Use of sodium aurothiomalate during lactation. Rane A. Surg Gynecol Obstet.58: 473– 479 289. Saxe V. McCarthy PT. Lee C. Amino N. Mock RE. Wischnik A. Koren G. Schneiderman J. Nifedipine transfer into human milk. Nefopam excretion in human milk. Excretion of gold into human breast milk. Levonorgestrel concentrations in maternal and infant serum during use of subdermal levonorgestrel contraceptive implants. 2000. Am J Obstet Gynecol. 1981. Convulsions in a breast-fed infant after maternal indomethacin [letter]. Nath B. J Hum Lact. 1982.2: 215 257. Methadone assays in pregnant women and progeny. Pitkin RM. Dahlstrom B. Ostensen M. Br J Clin Pharmacol. Bullingham R. Laumas KR. Ilett KF. Am J Obstet Gynecol. Clarke AK. 1934. Eur J Clin Pharmacol. McCormick CC. Ogbuokiri JE. Graham EA. Lloyd J. Williams KI. Moretti ME.48:541–543 251. Eeg-Olofsson O. Human breast milk concentration of moxalactam. Convulsions in a breast-fed infant after maternal indomethacin [letter]. Malmros I. Postellon DC. Transplacental passage and breast milk concentrations of hydralazine. Jerez E. Cohn RD.248. Hatcher RA. Am J Obstet Gynecol. Wojnar-Horton RE. Wallach RC. Steen B. Atkinson H. 1984. Valdes G. Affrime MB. Kristensen JH. Johnston A.17:368 –369 254. A study to evaluate the passage of ibuprofen into breast-milk. Lancet. The excretion of ketorolac tromethamine into breast milk after multiple oral dosing. Ehrenkranz RA. Symchowicz S. Maloof F. Can Pharm J. 1989. Dam H. The excretion of orally ingested nitrofurantoin in human milk. Br J Clin Pharmacol. Secretion of the antidiarrhoeal agent loperamide oxide in breast milk. Cote CJ. Bode HH. Yapp P. Chiang PK. 1990. 1970.10:592–597 282. Hackett LP. Ann Intern Med. Malkani PK. Keegan KA. Kenepp NB. Eur J Clin Pharmacol. Belton EM. Holmdahl KH. Bolme P. Am J Obstet Gynecol. Harzer G. Wallach RC. Disposition of maternal ketoconazole in breast milk. 1990. Methadone distribution and excretion into breast milk of clients in a methadone maintenance programme.03 mg) on breastfeeding. Thrupp LD. Dusci LJ. Weiss EL.157:446 – 447 294. Drug Intell Clin Pharm. Duchin KL. 1984. Excretion of ibuprofen into breast milk. Transfer of labetalol into amniotic fluid and breast milk in lactating women. Bialy G.28:234 –239 279.32:751–754 259. 1976. Higgins JE. Haug M. 2000. Nation RL. Naproxen excretion in milk and its uptake by the infant. 1986.151:490 – 496 281. 1985. Kulas J. Myklebust G. Von Kries R. Ackerman BA.12:393–396 301. Eur J Clin Pharmacol. 1965. et al. The breast milk excretion of mefenamic acid. 1989. Bennett PN.45:389 –390 264. Lownes HE. Clin Pharmacol Ther. Radioactivity in the milk of subjects receiving radioactive 19-norsteroids. Tomassen Y.148:348 –349 300.21:417– 419 252. Ingemarsson I. 1955. J Hum Lact. Methadone levels in human milk. Br J Clin Pharmacol. 1997. Pincus G.38:426 262. 1984. The elimination of morphine and quinine in human milk. J Hum Lact.
Lancet. Mirkin B. Herreros C. de Swiet M. distribution. Mattiasson I. 1983. Br J Clin Pharmacol. Pulver R. oxychlordane. Goulding R. 1979. New York. Organo-chlorine pesticide residues in human fat and human milk. Stillwell WG. Med J Aust. Am J Dis Child. 1965. Nowlin J. Dev Pharmacol Ther. Horning MG. Hackett LP. Seip M.1:736 –737 324. Duncan BR. Valproic acid in breast milk: how much is really there? Ther Drug Monit. Malkasian GD Jr. De Swiet M. Blumenthal P. Gilford P. Berlin CM Jr. Transfer of terbutaline into breast milk. Occupationally derived chemicals in breast milk. Lonnerholm G. von Kobyletzki D.70:241–250 370. Pseudoephedrine and triprolidine in plasma and breast milk of nursing mothers. Identification and quantification of drugs and drug metabolites in human breast milk using gas chromatography mass spectrometry computer methods.6:272–276 351. Fertility regulation in nursing women: VIII. 1975. Int J Cancer. de Chateau P. Stillwell RN. Nature. 1969. Montesano R. Hellenic Soc Chemother. 1977. Adamovic VM. Kaye CI. fetal localization. Mogensen F. Armstrong JF. Scand J Gastroenterol. Procainamide excretion in human milk. Ilett KF. Am J Ind Med. et al. 1973. Verabreichung von irgapyrin bei schwangeren und wochnerinnen. Cooppan RM.125:814 – 817 369. O’Brien C. Tatton JO. Pyridostigmine in human breast milk. 1989. J Trop Med Hyg. 1987. 1984.8:19 –29 356. et al. J Pharm Sci. MMW Munch Med Wochenschr. McKenzie SA. Sagranes R.18:453– 456 310. neonatal cord blood and sera of pregnant women. DDT in human milk. Selley JA. plasma concentrations in newborns and passage into breast milk. Favism in a nursing infant. quantified by combined monoclonal antibody immunoaffinity chromatography HPLC. Bull Environ Contam Toxicol.36:147–152 360. Krees SV. Br Med J. Becker PJ.54:240 350. Lindstrom B.4:791 340. Niesen M. Knirsch AK.102:631– 633 318. 1982. USA.43:860 – 862 323. Stern RM. Lindstrom B. 1956. Werthmann MW JR. Tolbutamide orinase in human breast milk. Posner AC.113:413– 422 368. Ouest Med. Plasma. 13:891– 894 357. et al. 1987.54:366 –368 328. von Unruh GE. J Pediatr. Lindberberg C. 1972. Francoual C. Keefe TJ. Br J Clin Pharmacol. heptachlor. Bull World Health Organ. 1980. Chlordane residues in human milk. heptachlor epoxide. 78:329 –337 313. Athens.18:901–906 325. Hall AJ. Pittard WB III. Am J Cardiol. Eur J Clin Pharmacol. Zolpidem excretion in breast milk. Greenberger PA. 1961.207:726 –728 365.41:217–221 337. Resman BH. Eur J Respir Dis Suppl. J Toxicol Toxin Rev. 1975. Propylthiouracil in human milk: revision of a dogma. Karlberg B. Into-Malmberg MB. Ilett KF. Press J.57:518 –520 342. Arnauld R. Hertz J. 1996. Nyberg L. and mirex.1:687 349. Carcinogenesis. 1989. Jusko WJ. Spironolactone: relationship between concentrations of dethioacetylated metabolite in human serum milk. Helweg J.37:245–248 354. Tessari JD. Excretion of propoxyphene and norpropoxyphene in breast milk. Quantitative excretion of Senokot in human breast milk.34:222–224 322. J Clin Pharmacol. Aflatoxins in breast milk. 58:263–266
THE TRANSFER OF DRUGS AND OTHER CHEMICALS INTO HUMAN MILK
. Kampmann JP. Further observations on the use of tetracycline hydrochloride in prophylaxis and treatment of obstetric infections.32:603– 622 319. Propranolol therapy during pregnancy and lactation. Lumbroso P. Maxwell SM. Goehrs HR. Boreus LO.1:31–39 335. Schaffner W. Quinby GE. Manion JC.134:87–91 339. erythrocyte human milk levels of free amino acids in lactating women administered aspartame or lactose.31:625– 627 352. Konicoff NG. Piroxicam in human breast milk. Atkinson AJ Jr. Filer LJ Jr. Williams RH. J Pediatr. Dusci LJ. 1955:594
341.97:839 – 841 336. Johansson BW.6:480 346.59:277 327. Bondesson U.14:869 – 871 334.100:596 –598 359. 1983. Sodium valproate and pregnancy.14:565–567 326. Proceedings of the 8th International Congress of Chemotherapy. west Africa. Wojnar-Horton RE.40:328 –333 355. 1985. 1992. Roberts MJ. Primavesi CA. Odeh YK. 1974. Br J Clin Pharmacol. Yaffe SJ. Miller RD. et al. Chaiken P. Arch Dis Child. Progesterone plasma levels and contraceptive efficacy of a progesterone-releasing vaginal ring. Waller ES. Hardell LI.309. Br J Clin Pharmacol. Savage EP. Mutiro CF. 1984. Hillion D.50:894 – 896 315. Cadmium concentrations in milk and blood of smoking mothers. Jackanicz TM. Chetsanga CJ. et al. Hill LM. Letter: excretion of propranolol in human breast milk. Transfer of pyrimethamine in human milk. DDT concentrations in human milk. Foulds G. and possible teratogenic effects. National study of chlorinated hydrocarbon insecticide residues in human milk. 1976. Leuxner E. Wojnar-Horton RE. Groshong T.25:518 –523 361.53:324 –328 316. Clin Pharmacol Ther. I. Excretion of sotalol in breast milk. Zarba A. Suprofen concentrations in human breast milk. Jandorf BJ.38:692– 696 333.25:959 348. Ostensen M. Hackett LP. Wild CP.32:247 321. Alexander FW. Roburn J. Moiel RH. Shute GT. Thiouracil: its absorption. Durham WF. Br J Obstet Gynaecol. Lewis PJ. Clin Pharmacol Ther. Jusko WJ. Disposition of salicylazosulfapyridine (Azulfidine) and metabolites in human breast milk. chlordane. Marti-Ibanez F. 1956. Frederiksen MC. 1983. 1944. J Pediatr.65:535–539 366. Butz RF. Diphenylhydantoin: placental transport. Aberg H. Levitan AA. Acta Anaesthesiol Scand. Findlay JW.2:66 – 69 364.19:55–56 347. 1980. Qvist T. 1967. J Pediatr. The use of quinidine sulfate throughout pregnancy. Ritzen CA. 1965. Ladik CF. Theophylline secretion into breast milk.35:675– 680 320. 1984. Akiyama K. Organochlorine pesticides in Western Australian nursing mothers. Excretion of oxprenolol and timolol in breast milk.293:1154 317. Osterman PO. Infection. Aflatoxin M1 in human breast milk from The Gambia. Mangurten HH. Chasin M. 1982. Antibiotics Annual 1954 –1955. NY: Medical Encyclopedia Inc. May mothers given warfarin breast-feed their infants? Br Med J. Lonnerholm G. Mod Probl Paediatr. and excretion. Hoffman F. Psaila-Savona P. 1993. Hill RM. Horii S. 1981. 1983. 1993. Pionneau FA. Emanuel B. Geographic distribution of dieldrin. Sulphasalazine treatment during breast feeding. Clin Pediatr. Sailstad JM. 1973. 1973. 1977. Miller RD.109:2173–2181 358. Tolmetin in breast milk. Toxicol Lett. Sioufi A. Agnew JE. Pons G. Orme ML. Sulfisoxazole secretion into human milk. Tetracycline in breast milk. Arch Dis Child. de Vries HR. Kay GA. Wolff MS. Yurchak AM.66:1203 332. 1987. Kennedy B. Concentrations of thiopentone in mature breast milk and colostrum following an induction dose. 1975. Baker GL. Am J Epidemiol. Secretion of prednisolone into breast milk. Some observations concerning the ratio of the intake of organochlorine insecticides through food and amounts excreted in the milk of breast-feeding mothers. N Engl J Med. Contraception. Jarnerot G. 1980. 1971. Kaneko S. Eur J Clin Pharmacol. Stevens MF.1:1564 –1565 353. Kunka RL.91:477– 480 362. Clin Pharmacol Ther. 1985. 1984. J Nutr. Bauer JH. Froescher W. Kauffman RE. Warren JT.11:144 –149 345. 1974. Ticarcillin serum and tissue concentrations in gynecology and obstetrics. Lertratanangkoon K. Dalhoff A. Egan H. Glazier H. 1976. eds. 1983. Locker DJ. Pediatrics. Yapp P. Distribution and excretion of sumatriptan in human milk. Bouwman H. Reinecke AJ.29:277–278 331.23:613– 627 344. J Clin Invest. Lundberg D. 1979. Med Ann Dist Columbia. Diaz S. Stegink LD. Zajicek J. Br J Clin Pharmacol. Br Med J. et al.20:280 –285 367. J Pediatr.90:961–965 311. 1977. Wild CP.158:238 –241 371. Eur J Clin Pharmacol. Johansen K. Etude du passage de la trimethoprime dans le lait maternel. 1990. neonatal metabolism. Insecticides in human breast milk. Entry of prednisone into human milk. Propranolol in human plasma and breast milk. Phelps DL. Pharmacokinetics of prednisolone transfer to breast milk. Neonatal bromism secondary to maternal exposure in a photographic laboratory. 1984. Transfer of DDT used in malaria control to infants via breast milk. Verapamil and norverapamil in plasma and breast milk during breast feeding. Silverman BK. Nau H. Andersen LW.25:829 – 830 314. The passage of trimethoprim/sulphamethoxazole into breast milk and its significance. Smith V.98:84 – 86 312. Clyde DF. 1979. Drug Intell Clin Pharm. Ebell GF.15:73–79 329. Acta Pharmacol Toxicol (Copenh). Salter AJ.31:30 –32 343. Acta Paediatr Scand. Lindemeyer H. 1992. Watson JT. Pape B. Oxprenolol placental transfer. 1979. Ryan JR. Apeagyei F. Miyazaki T. Luck W. Prigot A. Am J Cardiol. Bakken AF. In: Welch H. Paech M. Sokic B. Smiljanski MJ. 1987. Dusci LJ. Karim Z. J Pediatr. Welch RM. 1978.42:4 –5 330.23:385–390 338. 1983. Yamagishi T. Sulbactam kinetics and excretion into breast milk in postpartum women. et al. Wilson DJ. Hansen JM. Guillet P. 1980. 1979. Fidler J. Anderson P. Venkataramanan R. Radisch B. Schoenfeld A. Obstet Gynecol.4:259 –281 363. Bull Environ Contam Toxicol. Breast milk distribution of theobromine from chocolate. 1985. Katz FH. Thrupp LD. Aflatoxin detected in human breast milk by immunoassay.
1977. Humphrey H. Padgett DE.302:1450 –1453 Wickizer TM.372. Koos BJ. Bull Environ Contam Toxicol. Filer LJ Jr. J Pediatr.
maternal and cord blood. Majeed MA. 392. Brilliant LB. Effect of maternal fluorine intake on breast milk fluorine content. Rev Med Interne. and milk. Esala S. 1980. Schaffner W. Simpson WJ.299:317–323
AMERICAN ACADEMY OF PEDIATRICS
. Arch Toxicol. Pollutants in breast milk: PCBs and cola-colored babies [editorial].23:104 –106 373. Lead in breast milk. Arch Environ Health. Lead and cadmium in breast milk. 1978. Ellenberg HA. 1981. Clarkson TW. Sternowsky JH. Greenwood MR. 1968. Vuori E. Ando M. Pustilnik N. Hirano S. Salinas ME. Le passage dans le lait des aliments ou medicaments absorbes par denourrices.
386. Saldivar L.
389. Hexachlorophene concentrations in human milk. Arch Toxicol. Pediatrics.126:390 – 409 382. 391. J Pediatr. An investigation of fluoride concentration in the milk of nursing mothers. Baum CR.68:411– 415 Bagnell PC. Polychlorinated biphenyl contamination of nursing mothers’ milk in Michigan. Leviton A.140:836 – 841 Miller RW. Lead in milk and infant blood: a dose-response model. Nyhan WL.2:643– 646 Wickizer TM. 1982. Breast-milk monitoring to measure Michigan’s contamination with polybrominated biphenyls. J Toxicol Environ Health. Mercury in human
384. Methyl methacrylate levels in the breast milk of a patient after total hip arthroplasty. Wessolowski R. 1934. Price H. Testing for polychlorinated biphenyls in human milk. Mercury toxicity in the pregnant woman. 1977. Bagniewska A. 387. J Arthroplasty.51:198 375. West RW. Doherty RA. Namihira D. Tuba J. Br J Nutr. Bloomer AW. Lancet. Needelman H.71:132–137 Brilliant LB. Itoh Y. Carreon GJ. Pollutants in breast milk. N Engl J Med. placenta. 1995. Brilliant LB. 388.
385. Proc Soc Exp Biol Med. Am J Obstet Gynecol. Am J Public Health. Filer LJ Jr. Studies of infants postnatally exposed to methylmercury.85:81– 84 383.151:565–567 Hersh J.40:283–286 378.
390. 1976. Sweetman L. Copeland R. Lead in human blood and milk from nursing women living near a smelter in Mexico City.117:1047–1048 Higginbottom MC. N Engl J Med. Tilden R.97:932 381. Damstra T. Pitkin RM. Obstructive jaundice due to a chlorinated hydrocarbon in breast milk.13:167–169 377.38:225–232 380. Can Med Assoc J. Baker GL.10:91–92 Stegink LD. megaloblastic anemia neurologic abnormalities in a vitamin B12-deficient breast-fed infant of a strict vegetarian. Amin-Zaki L. Elhassani S. Proc Soc Exp Biol Med. A review. Transfer of hexachlorobenzene (HCB) from mother to newborn baby through placenta and milk. 1976. and newborn infant. 1975. 1978. Pediatrics. Dreyfus-See G. homocystinuria. 1996. Reynolds WA. Rabinowitz M. 1981. Bono JV. Helle A. Bahns JA. Isbister J.90:510 –511 Rogan WJ. Van Amburg G. 1985.48:201–204 374. 1993. Shannon MW. 1972. Wilson DJ. Monosodium glutamate: effect on plasma and breast milk amino acid levels in lactating women. fetus. Longo LD. J Oral Med. 1985. 1974. Mancuso CA. A syndrome of methylmalonic aciduria. Higher levels in urban vs rural mothers during the first 3 months of lactation. 1985.57:41– 45 379.56:195–200 376.