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Abstract

From the perspective of children’s health, exclusive breast-feeding for at least the first 6 months of life is generally preferable to formula-feeding.
What are the principles for choosing whether and how to treat a nursing woman, without denying her access to useful drugs or harming her breastfed child?
Most drugs taken by nursing women are present in their milk, and breastfed children are exposed to their adverse effects. Generally speaking, there has been little evaluation of the dose to which children are exposed through breast-feeding and the clinical effects of this exposure; both are influenced by many factors.
The first principle is to avoid exposing the child to unnecessary drugs by establishing the value of treatment and its harm-benefit balance for the mother.
The second step is to take into account the effects of the drugs under consideration during breast-feeding. Summaries of product characteristics (SPCs) contain insufficient information on breast-feeding. A few reference books and websites provide evaluation data on the transfer of drugs into breast milk, and their known effects and foreseeable adverse effects on children, according to their age and health status.

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From mother to child
Prescrire Int 2017:
26 (188): 283.
Pdf, free