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NUTR 2050 (75)
Chapter 7

Chapter 7.docx

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University of Guelph
NUTR 2050
Simone Holligan

Chapter 7Low milk supplyMost common reason to stop breastfeedingUsually caused by the mother not pumping or breastfeeding enough or a poor latch while pumpingFenugreek goats rue and milk thistleare common herbal Galactogogues which can increase milk supply but they are not FDA approved and studies have not been done on the effectivenessOral contraceptives with estrogen may decrease milk supplyMetoclopramideis the most commonly used drug to increase milk supply may cause side effects such as fatigue drowsiness and diarrhea can also increase depression anxiety confusion and dizziness or headacheDomperidone is commonly used outside of the US it is not approved by the FDAMaternal Medications9099 of breastfeeding women receive some type of medication in the first weekpostpartum most medications are excreted in the breast milk Important to considerPharmacokinetic properties of the drugMilkplasma ratio of the drugDrug exposure indexInfants ability to absorb detoxify and excrete the agentDose strength and durationInfants age feeding pattern total diet and health Seven categories in risk factors 1Cytotoxic drugs that may interfere with cellular metabolism of the infant 2 Drug abuse has adverse effects on the breastfeeding infant 3 Radioactive compounds require cessation of breastfeeding at least temporarily 4 Drugs which have unknown effects 5 Drugs that do have effects on the infant should be given with caution to the mother 6 Maternal medications usually compatible with breastfeeding 7 Food and environmental agents having no effect on breastfeeding The Breastfeeding and Human Lactation study Center at the University of Rochester always updates its knowledge of more than 3000 drugsThere is also TOXNET lactmed database and textbooks such as Medications and mothers milk Physicians Desk Reference PDR is not a good source because the info comes from pharmaceutical companies Antihistamines cold remedies and decongestants are said to be compatible with breastfeeding but they may suppress lactation Oral contraceptives and lactationNo evidence of harm but not many studies availableW
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