What antihypertensive drugs are used during breastfeeding?

  Breastfeeding is an important period in a woman’s life and an important contribution to human development. Women with chronic hypertension are deeply concerned about how to safely nurse a healthy baby after a safe pregnancy and childbirth, and by first-time parents. The general principle should be to take into account the safety of both mother and baby.  Based on available research data, the Clinical Guideline Development Group and the American Academy of Pediatrics recommend labetalol, propranolol, nifedipine, and captopril for breastfeeding mothers, but do not recommend ACEI-like antihypertensives for mothers of preterm infants. Amlodipine and ARB are not recommended due to lack of safety data. The details are described later: 1. Diuretics: are relatively safe for infants, the main problem is that they may cause a reduction in breast milk and lack of milk. Such as hydrochlorothiazide and furosemide.  2, beta-blockers: Labetalol and Prenalol are available during lactation. However, other beta-blocking drugs such as metoprolol and atenolol are not recommended, and these drugs may affect the infant.  3. Methyldopa: low concentration in breast milk, but due to the direct action on pituitary gland to inhibit the release of prolactin, it can theoretically reduce breast milk. To date, no adverse effects on newborns have been reported. There are no reports that this product can be secreted into breast milk, so it is not recommended to breastfeed during treatment.  4. Risperdal: It can be secreted into breast milk, but no significant harmful effects have been reported. It is not recommended for women with a tendency to postpartum depression.  5.Captopril: The amount in breast milk is about 0.6% of the mother’s. If the concentration in breast milk is safe for the infant, the maximum dose for the mother is 300mg/day, otherwise it can affect the fetus and the kidney of the newborn, and should be avoided.  6, calcium antagonists: Verapamil, nifedipine and diltiazem have been studied, and the WHO study group on lactation has classified verapamil as a drug that can be applied during lactation, which can be secreted through breast milk. Diltiazem can also be ingested in small amounts by infants from breast milk, but WHO has not determined its safety.