Anti-psychotics and breast-feeding
What about those who suffer from puerperal psychosis and who are put on anti-psychotics such as Haloperidol?
Anti-psychotics, including Haloperidol, Chlorpromazine and Flupenthixol, are found in small amounts in breast-milk. Caution regarding breast-feeding will be part of the management strategy of this difficult condition.
"Cytotoxics" (Chemotherapy) and breast-feeding
What if somebody is taking anti-cancer drugs?
If one is taking cytotoxic drugs for cancer treatment, breastfeeding should be avoided.
Breast-feeding after organ transplant
Organ transplant is usually followed by long-term use of immuno-suppressant drugs. What is the advice in such a case?
A few women become pregnant following organ transplantation, especially of the kidneys. Breast-feeding should be avoided in women who are on drugs such as Cyclosporin or Azathioprine.
In most cases, lengthy and thorough counseling will have taken place even prior to conception and such an individual is likely to be already well informed in these matters.
Hypertension medication and breast-feeding
What if a newly delivered mother is taking antihypertensives?
Treatment for raised blood pressure is quite varied after delivery. Many drugs that are unsafe to use in pregnancy are perfectly acceptable with breast-feeding. Popular antihypertensive drugs that are known to be safe with breast-feeding include beta-blockers (such as Atenolol and Labetalol); Nifedipine, Hydralazine, Captopril and Methyl-dopa.
It is always advised to read the instruction leaflet coming with the medication especially bearing in mind that a lot of drugs could be in combinations. These in some cases make them unsuitable to use whilst breast-feeding.
What about diuretics?
The popular diuretic Furosemide (also called Frusemide) is safe with breastfeeding. So are the related diuretics Bumetadine and Torasemide.
Thiazide diuretics, on the other hand, have a potential for suppressing lactation, especially in high doses. These should be avoided whenever possible. They include Bendroflumethiazide (Bendrofluazide) and Chlortalidone (Hygroton®).
Asthma drugs and breast-feeding
What about drugs used to control asthma?
Salbutamol and Terbutaline, the most common drugs used for asthma, are safe. They do appear in milk but in very small inconsequential quantities.
Theophylline and Aminophylline may cause mild infant irritability but are generally safe.
Steroids used in asthma usually by inhalation are generally safe as the amount appearing in breast milk are insignificant. For those taking high doses of oral prednisolone (above 40 mg daily), it is advised that the baby’s adrenal function is monitored as high doses can suppress it.