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Lactation: Drug Information

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Conditions

Pharmacological Management of Mastitis
Ensure that mother is having symptoms of bacterial infection:
1. Breast is not emptying with the baby or the pump
2. Flu like symptoms
3. Fever
Academy of Breastfeeding Medicine Protocol 4 Mastitis
Breastfeeding: A Guide for the Medical Profession, Ruth A. Lawrence MD and Robert M. Lawrence MD
* Note: The above link will only work from WR-B networked computers.
 

Candidal Infection: Mother and Child
Both mother and baby must be treated at the same time.‚Äč

Treatment for fungal infection in nipple/ areola: burning pain felt during or after feeds after first week postpartum, not alleviated by positional change; unilateral or bilateral; shiny, erythemic; dry/peeling.

Mother: Apply small amounts of antifungal cream (mycostatin, mycolog or Newman’s ointment) to areola and nipple(s) after feeding for 14 to 21 days.

Infant: Nystatin

Premature neonates:
100,000 units (1 ml) four times per day. Place ½ dose in each side of mouth. Avoid feeding for 5 to 10 minutes

Neonates and Infants:
200,000 units (2ml) four times per day. Place ½ dose in each side of mouth. Avoid feeding for 5 to 10 minutes

Treatment for fungal infection in ductal tissue in the breast (symptoms stabbing shooting pain deep in the breast)

Mother:
Fluconazole (diflucan) 200 mg loading dose followed by 100mg/day for 14 days

Infant:
Nystatin

Premature neonates:
100,000 units (1 ml) four times per day. Place ½ dose in each side of mouth. Avoid feeding for 5 to 10 minutes

Neonates and Infants:
200,000 units (2ml) four times per day. Place ½ dose in each side of mouth. Avoid feeding for 5 to 10 minutes

Lawrence and Lawrence 2016 Chapter 13, Transmission of Infectious Diseases Through Breast Milk and Breastfeeding, Breastfeeding A guide For The Medical Profession, Eighth Edition Philadelphia, Pa. Elsevier.
* Note: The above link will only work from WR-B networked computers.

LactMed (Drugs and Lactation Database)

The LactMed® database contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate. All data are derived from the scientific literature and fully referenced. A peer review panel reviews the data to assure scientific validity and currency.

Updates: LactMed is updated monthly.

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