Lactation and stuff

How long does the AAP recommend exclusive breastfeeding?

For the first 6 months of life

How long should breastfeeding continue with complementary foods if feasible?

For at least 2 years

How many additional calories should a breastfeeding mother consume?

330–400 kcal/day

Which supplements should breastfeeding mothers continue?

Prenatal vitamins and omega-3 supplements

How much vitamin D should babies receiving breast milk receive?

10 mcg (400 IU) daily

Why may breastfed infants need iron supplementation?

Human milk contains very little iron

When should iron supplementation generally begin in breastfed infants and at what dose?

At 4 months of age at 1 mg/kg/day

How long should breastfed infants receive supplemental iron?

Until adequate iron is obtained from iron-rich solid foods, usually around 6 months of age

What drug characteristics increase excretion into breast milk?

Non-ionized, small molecular weight, low volume of distribution, and high lipid solubility

Can a mother generally continue breastfeeding with a cold, influenza, or most other infections?

Yes

What resources can be used to check medication safety during breastfeeding?

LactMed or Briggs' Drugs in Pregnancy and Lactation

What medications are preferred for postpartum pain during breastfeeding?

Acetaminophen or ibuprofen

Which analgesics should NOT be used by breastfeeding mothers and why?

Codeine and tramadol; Risk of excessive sleepiness, breathing difficulty, and death in the infant

What can happen when a breastfeeding mother taking codeine is a CYP2D6 ultra-rapid metabolizer?

High concentrations of active opioid metabolite can develop, increasing the infant's risk of serious toxicity or death

Is breastfeeding recommended for women with documented HIV infection in the United States?

No, especially without ART or sustained viral suppression

What should a woman with suspected HIV infection do regarding breastfeeding?

Stop breastfeeding until HIV is ruled out with appropriate testing

Which substances should be completely avoided during lactation?

Chemotherapy, illicit drugs, and radioactive compounds used for treatment or diagnostic studies such as iodine

Which medications should be avoided during lactation if possible due to potential infant risk?

Amphetamines, amiodarone, ergotamine, lithium, metronidazole, phenobarbital, and statins

What may be done if a breastfeeding patient must use a medication with significant infant risk?

Pump and dispose of breast milk when drug concentrations are highest when appropriate

Which medications may decrease milk production during lactation?

Antihistamines such as diphenhydramine and cetirizine, decongestants such as pseudoephedrine, and anticholinergics

What monitoring is recommended when a mother takes medications during lactation?

Monitor the infant for adverse effects caused by maternal medication use