British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology practice British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology practice | Rheumatology | Oxford Academic We use cookies to enhance your experience on our website.By * Rigour of development * The guideline * Applicability and utility * Supplementary data * Data availability statement * Funding * Acknowledgements * References Article Navigation Article Navigation Journal Article Corrected proof Editor's Choice British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology
, due to concerns regarding transfer of medication via breast milk. With further pharmacokinetic information and documented experience now available, this advice is no longer applicable. Interruption to breastfeeding carries short and long-term risks, including breast engorgement and mastitis, dehydration, and the health implications of earlier cessation of breastfeeding. Most medications used in anaesthesia are transferred in small amounts to breast milk. Concerns about infant effects relate to four factors. 1. Amount transferred: The Relative Infant Dose (RID)2 measures the percentage of any medication per daythat results in the breastfed infant when the medication is administered to the breastfeeding patient. Medications are considered “safe” if the RID is <10%. Most medications used
of breastfeeding. Most medications used in anaesthesia are transferred in small amounts to breast milk. Concerns about infant effects relate to four factors. 1. Amount transferred: The Relative Infant Dose (RID)2 measures the percentage of any medication per day that results in the breastfed infant when the medication is administered to the breastfeeding patient. Medications are considered “safe” if the RID
information on: * recent respiratory symptoms * feeding including: * duration of feeds (feeding more difficult with more severe illness) * breastfeeding * underlying medical conditions including chronic lung disease, congenital heart disease and chronic neurological conditions * chromosomal abnormalities including Trisomy 21 * indigenous status * prematurity * post-natal exposure to cigarette
. Other drug categories (pain management; NSAIDs and low dose aspirin; anticoagulants; bisphosphonates; anti-hypertensives; and pulmonary vasodilators) are considered in the BSR guideline on prescribing drugs in pregnancy and breastfeeding: comorbidity medications used in rheumatology practice (https://doi.org/10.1093/rheumatology/keac552). All recommendations in this guideline were formulated
-on-Supporting-Surgical-Trainees-Who-Are-Breastfeeding.htm?fbclid=IwAR2XxjuO-G8wGGAK1jGVLmgF59iMVosDFQaiC1ySriI3fPzlVv1q9kGc1tY. Accessed September 5, 2020. 8. American Academy of Family Physicians. Breastfeeding and Lactation for Medical Trainees. Available at: https://www.aafp.org/about/policies/all/breastfeeding-lactation-medical-trainees.html. Accessed September 4, 2020. 9. Society for Interventional
medicine physicians, and lactationconsultants. For patients requiring intensive medica-tion management (e.g., transplant patients), a phar-macist familiar with medication resources in lactation(e.g., LactMed,59e-lactancia,61InfantRisk Center60)should be identified. Care providers should be familiarwith the safety of antibiotics in breastfeeding (see‘‘Medications’’ section). Other
-Trimester Pregnancy Exposure to Venlafaxine or Duloxetine and Risk of Major Congenital Malformations: A Systematic Review. Basic Clin Pharmacol Toxicol. 2016 Jan;118(1):32-36. March of Dimes 2016 Premature Birth Report Card. Available from http://www.marchofdimes.org/materials/premature-birth-report-card-united-states.pdf Massachusetts General Hospital Center for Women’s Mental Health: Breastfeeding & Psychiatric Medications. Available from https://womensmentalhealth.org/specialty-clinics/breastfeeding-and-psychiatric-medication/ Muzik M, Hamilton SE. Use of Antidepressants During Pregnancy? What to Consider When Weighing Treatment with Antidepressants Against Untreated Depression. Matern Child Health J. 2016 Nov;20(11):2268-2279. National Center for Health Statistics. Births: Final data for 2014
health component, previous breastfeedingexperiences, gender and cultural influences.70(III-a)Areas of suggested education include the risks of artificialfeeding, the physiology of lactation, management of com-mon breastfeeding problems, medical contraindications tobreastfeeding, and practical skills to assess latch and ap-propriate milk transfer. Make educational resources avail-able for quick
and safe to prescribe during pregnancy and while breastfeeding. 1 Medications should only be prescribed after careful discussion with the mother. When symptoms are severe, involving a psychiatrist is advisable.15 Reference should be made to the most recent TGA Therapeutic Guidelines and Medications Handbook for current advice for use of medication in the general population. 4.10 Severe mental illness
) management during the post-partum period. As first-line strategies, experts recommend treating mood symptoms during pregnancy and maintaining a pharmacological treatment, even in euthymic or stabilized patients. First-line options include only medications with no teratogenic risk, and during breastfeeding, only medications without evidence of adverse effects in nursing infants. The expert consensus