Transcript Maternal Medications - American Academy of Pediatrics

Copyright © 2003, Rev 2005 American Academy of Pediatrics
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Pituitary releases
prolactin and oxytocin.
Stimulation of
nerve endings
in mother’s
nipple/areola
sends signal
to mother’s
hypothalamus/
pituitary.
Hormones travel
via bloodstream
to mammary gland
to stimulate milk
production and
milk ejection
reflex (let-down).
Infant suckles
at the breast.
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Maternal Factors
That Support
Optimal Lactation
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Normal breast anatomy
Intact neuroendocrine reflex
Good general health and
nutritional status
Effective support system
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Nutrition During
Lactation
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Generally healthy diet
Drink fluids to thirst
Adequate protein and calories
Calcium
Multivitamin supplement
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Maternal Medications
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Most are
compatible with
breastfeeding.
Medication use
in pregnancy is
not the same as
medication use in lactation.
Weigh benefits against risks.
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Maternal Medications
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Choose the safest drug available.
Prescribe medications for the
shortest length of time appropriate.
Use short-acting formulations.
Administer just after breastfeeding.
Monitor infant for side effects.
Report adverse effects to the
proper authorities.
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Maternal Medications
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References
AAP Committee on Drugs
 Hale: Medications and
Mothers’ Milk
 Lawrence and Lawrence:
Breastfeeding: A Guide for the
Medical Profession
 Briggs, Freeman, and Yaffe: Drugs
in Pregnancy and Lactation
 Lactation Study Center Drug
Data Bank, University of
Rochester, NY
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Copyright © 2003, Rev 2005 American Academy of Pediatrics
Breastfeeding
Counseling
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Advise moderation in caffeine
intake
Avoid alcohol
Encourage smoking cessation or
limited use
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Human Milk
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Colostrum
 Present in small volume
before delivery and in
first days after delivery
 High in host defense
proteins and
immunoglobulins
Transitional milk
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Human Milk
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Colostrum
 Present in small volume
before delivery and in
first days after delivery
 High in host defense
proteins and
immunoglobulins
Transitional milk
Mature breastmilk
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Twins
Premature infant
breastfeeding
breastfeeding
Photo © Nancy Wight, MD, FAAP
Photo © Ruth A. Lawrence, MD, FAAP
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Breastfeeding
Positions
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Mother
comfortable
Infant head in
straight line
with body
Tummy-totummy or
chest-to-chest
Photo © Ruth A. Lawrence, MD, FAAP
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Cradle Position
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Cross-cradle or
Transitional
Position
Photo © La Leche League International
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Side-lying Position
Photo © Roni M. Chastain, RN
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Clutch or
Football Position
Photo © Lori Feldman-Winter, MD, MPH, FAAP
Copyright © 2003, Rev 2005 American Academy of Pediatrics
Latch
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Stimulate
rooting reflex.
Take sufficient
areola into
mouth.
Flange lips
around the
breast—
“fish lips.”
Have wide
angle at corner of mouth.
Illustration by Tony LeTourneau
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Copyright © 2003, Rev 2005 American Academy of Pediatrics