How to safely administer medication to breastfeeding mothers

  The value of breastfeeding in terms of immunization and nutrition is no longer in doubt. Breast milk is the best source of nutrition for newborns and the only source of exogenous immunoglobulins to protect against infections. During the first week of life, breast milk contains immunoglobulins (IgG, IgA, and IgM), interferons, and other antimicrobial substances that allow for the implantation of probiotic flora in the gastrointestinal tract of the newborn. The various growth factors, cytokines, and gastric hormones contained in breast milk promote the development of a protective gastrointestinal barrier that activates the clearance of meconium that occurs during pregnancy. Other key benefits of breastmilk include high quality nutrition, promotes neurocognitive development, enhances immune function, and reduces the incidence of infectious diseases such as upper respiratory infections, otitis media, and necrotizing small bowel colitis by at least three times.  Almost all mothers want to give their babies the best breast milk, and once a breastfeeding mother gets sick, she is prone to several extremes: one is to refuse all medications and continue breastfeeding despite the possible side effects of the medications; the second is to refuse all medications, which may lead to disease progression and eventually affect breastfeeding; and the third is to stop breastfeeding as soon as she has taken the medications. So, when a breastfeeding mother must use medication, how can she choose the medication to try to control the disease without affecting breastfeeding or at least affecting breastfeeding?  Here, it is recommended to refer to Dr. Hale’s breastfeeding risk rating: L1 Safest Many breastfeeding mothers taking medications have not observed an increase in side effects to their infants. No risk to the infant has been demonstrated in controlled studies of breastfeeding women, and there may be little risk to the nursing infant; or the drug may not be absorbed and utilized orally in the infant.  L2 is safer There is no evidence of increased side effects in the limited number of studies of dosing in nursing mothers. and/or there is little evidence of risk for nursing mothers.  L3 Moderately safe No controlled studies have been conducted in nursing women, but the hazard of adverse reactions in feeding infants may exist; or controlled studies have shown only very mild, nonfatal side effects. This class of drugs should be used only after weighing the benefits to the fetus against the harms. New drugs with no published data are automatically assigned to this class, regardless of their safety.  L4 Possible hazard There is clear evidence of harm to the nursing infant or to maternal breast milk products. However, the benefits to the nursing mother outweigh the risks to the infant, for example, if the mother is in a life-threatening or serious illness and other safer drugs are not available or are ineffective.  L5 Contraindications Studies in nursing mothers have demonstrated a clear risk of harm to the infant or a high risk of clear harm to the infant from the drug. Application of this class of drugs in nursing women is clearly not beneficial. This class of drugs is contraindicated in nursing women.  Drugs in the L1-L3 class are generally safe and do not require discontinuation of breastfeeding for use.  Try to choose L1 and L2 drugs. Some L2 and L3 drugs have some precautions and warnings for use.