1, principles of medication during lactation
If there is no evidence that the advantages of drug abuse outweigh the disadvantages, we should try to avoid drug abuse;
Can be used locally, try to avoid systemic medication;
If drugs must be used, drugs with large molecular weight, low fat solubility, short half-life, low ratio of milk to drug and low pKa value should be selected;
For most drugs, the exposure of infants during pregnancy is significantly greater than that during lactation. Therefore, for most drugs, if they can be used during pregnancy, they can generally be used during lactation.
If it is necessary to use drugs that may affect breast-feeding babies during lactation, breast-feeding can be stopped during the medication period, and breast-feeding can be resumed after 5 half-lives of drug withdrawal (drug half-life can refer to the drug instructions).
2, the use of antibiotics
Penicillin, amoxicillin, cephalosporin, clindamycin and azithromycin can be used (all listed as Class B by FDA); Only a small amount of penicillin and cephalosporin is secreted into milk, which does not affect breastfeeding. It is very unlikely that children allergic to antibiotics or dysbacteriosis will cause diarrhea.
Note: Metronidazole, as one of the most commonly used drugs in oral clinic, was classified as Class C by FDA in the past because it can cause gene mutation in vitro, but the latest data show that Metronidazole has no teratogenic effect on human body. Now it has been classified as Class B by FDA, and the use of pregnant women has been lifted. The amount of metronidazole entering milk is very small, and there are no reports of its adverse reactions. However, the use of metronidazole during lactation will make the taste of milk worse, which should be avoided as much as possible during lactation. 200 1 AAP suggested that breast-feeding should be stopped after 12-24 hours if 2g dose is used; The mother uses metronidazole locally, and the serum concentration is very low, which does not affect breastfeeding.
Quinolones (including ciprofloxacin, levofloxacin, moxifloxacin, etc. ) are not recommended;
Tetracyclines (including tetracycline and doxycycline) are not recommended;
3. Application of painkillers
Acetaminophen, ibuprofen and codeine can be used during lactation; Avoid aspirin.
4, the application of anesthetic
Lidocaine (FDA classification B) and mepivacaine are relatively safe and can be used during lactation.
The trace adrenaline added in anesthetic is unlikely to enter the milk because of its short half-life and small dosage, so lidocaine containing adrenaline can be used during lactation.
At present, the most commonly used articaine in dentistry (FDA classification C) should be used with caution during lactation.
Step 5 Use mouthwash
Mouthwashes with chlorhexidine, cetylpyridinium chloride or xylitol as active ingredients are generally safe and can be used during lactation.
Attachment: FDA classification of drugs for pregnant women
The FDA classifies the safety of drugs used during pregnancy into five categories: A, B, C, D and X. Because of their harmfulness, some drugs can pose different degrees of harm due to different duration. Now the classification standard of FDA5 grade is described as follows.
Class A: In the study with the control group, women who were pregnant for 3 months did not see any signs of harm to the fetus (and there was no evidence of harm to the fetus in the next 6 months), which may have little effect on the fetus.
Class B: In animal reproduction research (no control study of pregnant women), no effect on fetus was observed. Adverse reactions in animal reproduction research have not been confirmed in women who are pregnant for 3 months (and there is no evidence that they are harmful to the following 6 months).
Class C: Adverse reactions (teratogenesis or embryo death or others) have been confirmed in animal studies, but no controlled study has been conducted in pregnant women. Such drugs can only be used after weighing the benefits to pregnant women greater than the harm to the fetus.
Class D: There is obvious evidence that it is dangerous to human fetus. Although harmful, pregnant women have absolute benefits after taking the medicine (for example, when pregnant women are threatened with death or suffer from serious diseases, other drugs are safe but ineffective), so they still need to use them.
Classification X: Studies on animals or people show that it can cause fetal malformation, and it is obviously useless for pregnant women to use such drugs. Pregnant women or pregnant women are forbidden to use such drugs.
6. Benefits of breastfeeding
1. Breastfeeding is beneficial to the healthy growth of babies. Breast milk, especially colostrum, contains rich nutrients that babies need. It is high-quality milk that no dairy product can replace. Breast-feeding is very beneficial to the healthy growth of the baby.
2. Breastfeeding is beneficial to the recovery of maternal health. The new mother changed physically and mentally through childbirth. If breastfeeding can be adopted after delivery, it can help the parturient recover the uterus, reduce the bleeding of female private parts, prevent postpartum anemia and promote physical recovery. At the same time, it also helps to postpone the pregnancy of new mothers.
3. Breastfeeding helps to enhance the baby's resistance and immunity. There are many antibiotics in breast milk, especially colostrum, which can resist infection. Disease-resistant people are not fully possessed by any other dairy products and foods, and are unique to breast milk. Therefore, the baby sucks breast milk, which enhances the baby's resistance and immunity and makes the baby less sick or not sick.
4. Breastfeeding is beneficial to the digestion and healthy development of infants. Because breast milk has many advantages, balanced nutrition and the best ratio, it is an advantage that other foods do not have or have at all. Therefore, breast-feeding is beneficial to the digestion and healthy development of infants.
5. Breastfeeding is beneficial to the relationship between mother and child. As the saying goes, mother and son are connected. New mothers can improve their love, care and affection for their babies by stimulating them to suck their nipples. Babies will feel safe and happy when they suck breast milk. Therefore, the emotion between mother and son is constantly communicating and progressing in this subtle way, and constantly improving and sublimating.
6. Breastfeeding is economical. Breast milk is not only beneficial to the healthy growth of babies and the recovery of new mothers, but also cheaper and more economical than other feeding products.
7. Breastfeeding is convenient and quick. Breastfeeding has many benefits, which are not only economical, but also convenient and fast. It's really convenient to eat with you, which is very suitable for babies to eat less and eat more. Because babies don't eat regularly and quantitatively like adults, they eat when they shout, and cry when they are slow, which is irregular. If you feed with other foods, it is difficult to meet these requirements and conditions, and only the owner of breastfeeding can adapt and meet them.
8. Breast milk is clean and safe. Breast milk is beyond reproach, it is the best food for feeding babies. It is safe, clean, non-toxic and has no side effects. It is incomparable to any other food. It is a "safe granary" provided by the new mother in the world for her baby.
9. Breastfeeding can reduce baby allergies. Because breast milk is clean, safe, non-toxic, without any side effects, and has natural antibiotics, antiviral agents and so on. Breastfeeding can greatly reduce and reduce the occurrence of various allergies in infants. If you feed with other substitutes, all kinds of allergies will inevitably occur, which will lead to the baby's bad taste, restless sleep and uncomfortable life, which will affect the baby's healthy growth.
10, breastfeeding can reduce the probability of ovarian cancer and breast cancer in women. Through investigation, statistics and analysis, scientists found that the chances of breast-feeding new mothers suffering from ovarian cancer and breast cancer are much lower than those of non-breast-feeding new mothers.