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ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017 / Academy of Breastfeeding Medicine in Breastfeeding Medicine, Vol 12, n°9 (Novembre 2017)
Titre : ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017 Type de document : texte imprimé Auteurs : Academy of Breastfeeding Medicine, Auteur ; Sarah Reece-Stremtan, Auteur ; Matilde Campos, Auteur ; Lauren Kokajko, Auteur Année de publication : 2017 Article en page(s) : pp. 500-506 Note générale : "A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols, free from commercial interest or influence, for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient." [Note de l'éditeur] Langues : Anglais (eng) Catégories : Analgésique
Composition du lait
Prise en charge de la douleur
Thérapeutique médicamenteuse de la mère
Note de contenu : "There is little rigorous information in the scientific literature about anesthesia or procedural sedation in breastfeeding mothers. Recommendations in this area typically focus on pharmacologic properties of anesthetic agents, limited studies of milk levels, and rare infant effects. In addition to medication concerns, additional perioperative considerations may impact a breastfeeding dyad's continued breastfeeding success when a mother undergoes anesthesia or sedation. Despite the lack of controlled studies regarding outcomes of breastfeeding in mothers receiving anesthesia, multiple review articles conclude that most mothers may safely breastfeed immediately following anesthesia.1–8 (IV) (Quality of evidence [levels of evidence IA, IB, IIA, IIB, III, and IV] is based on levels of evidence used for the National Guidelines Clearing House and is noted in parentheses.)9 Most recommendations for breastfeeding in the perioperative setting come from expert opinion rather than from extensive studies or trials. Up-to-date information on specific medications can be found on the United States National Library of Medicine website LactMed,10 with additional resources listed in Table 1. Medication guidelines discussed in this protocol may be extended to mothers in the immediate postpartum period; however, specific considerations for this population are detailed in ABM Protocol #28, Peripartum Anesthesia and Analgesia for the Breastfeeding Mother. The focus of this protocol is on anesthesia and analgesia for breastfeeding mothers outside the postpartum period." [Présentation de l'auteur] Permalink :
in Breastfeeding Medicine > Vol 12, n°9 (Novembre 2017) . - pp. 500-506[article]Estimation of Atenolol Transfer Into Milk and Infant Exposure During Its Use in Lactating Women / Ei Mon Phyo Lwin in Journal of Human Lactation, Vol. 34, n°3 (Août 2018)
Titre : Estimation of Atenolol Transfer Into Milk and Infant Exposure During Its Use in Lactating Women Type de document : texte imprimé Auteurs : Ei Mon Phyo Lwin, Auteur ; Cobus Gerber, Auteur ; Catherine Leggett, Auteur Année de publication : 2018 Article en page(s) : pp. 592-599 Langues : Anglais (eng) Catégories : Composition du lait
Consultant en lactation
Thérapeutique médicamenteuse de la mère
Résumé : "Abstract
Atenolol lactation information is limited, and controversy exists over the safety of its use during breastfeeding. In this study, important parameters including milk-to-plasma ratio, ratio of infant plasma to maternal plasma, infant daily dosage, and relative infant dose were investigated. The findings from this study add information to existing data about atenolol transfer in human milk. This may help guide health professionals in decision making regarding the safety of beta blockers used by mothers during breastfeeding.
The aims of the study were to quantify concentrations of atenolol in human plasma and milk, to evaluate atenolol pharmacokinetics in lactating women, and to investigate subsequent infant exposure to atenolol via mother’s milk.
In this prospective, longitudinal observational study, participants were lactating mothers (N = 3), 1 to 4 months postpartum, who had been taking atenolol for therapeutic reasons, and one 4-month-old breastfed infant. Eight milk samples were collected over 24 hr at different time points, together with a single blood sample from each lactating mother and the infant, and quantified using a new sensitive liquid chromatography mass spectrometry method developed for this study.
Peak milk concentrations of atenolol were observed in the women at 4 hr (Tmax) after oral administration. The dose-normalized maximum concentrations (Cmax) of all patients were similar. The mean milk-to-plasma ratio of the patients who were taking 25 to 100 mg of atenolol was 8.57%. In the mother–infant pair study, the ratio (%) of infant plasma drug concentration to maternal plasma drug concentration observed (18.87%) was similar to the relative infant dose estimated (18.20%). The relative infant dose values (13.96%-18.20%) for all patients were within 10% to 25% of maternal dosage.
Atenolol use during breastfeeding should be undertaken with some precaution. If clinically indicated, an alternate beta blocker may be preferred."
[Résumé de l'auteur]
in Journal of Human Lactation > Vol. 34, n°3 (Août 2018) . - pp. 592-599[article]n°136 - Juillet 2018 (Bulletin de Les Dossiers de l'Allaitement)
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Code-barres Cote Support Localisation Section Disponibilité aucun exemplaireProtocole ABM #15 sur l'analgésie et l'anesthésie chez la mère allaitante / Academy of Breastfeeding Medicine
Code-barres Cote Support Localisation Section Disponibilité aucun exemplaireSevere Hypernatremic Dehydration and Lower Limb Gangrene in an Infant Exposed to Lamotrigine, Aripiprazole, and Sertraline in Breast Milk / Caroline Morin in Breastfeeding Medicine, Vol. 12, n°6 (Juillet - Août 2017)
Titre : Severe Hypernatremic Dehydration and Lower Limb Gangrene in an Infant Exposed to Lamotrigine, Aripiprazole, and Sertraline in Breast Milk Type de document : texte imprimé Auteurs : Caroline Morin, Auteur ; Isabelle Chevalier, Auteur Année de publication : 2017 Article en page(s) : pp. 377-380 Langues : Anglais (eng) Catégories : Consultation pour l'allaitement
Consultation pour nourrisson
Maladie de la mère
Poids de l'enfant
Thérapeutique médicamenteuse de la mère
Résumé : "Background: Hypernatremic dehydration is well described in exclusively breastfed neonates, although life-threatening complications are rarely reported.
Materials and Methods: The present article describes a case of severe hypernatremic dehydration in a previously healthy term neonate. Other published cases of severe complications of hypernatremic dehydration are discussed.
Results: The exclusively breastfed neonate described had severe hypernatremic dehydration because of inadequate milk intake, with disseminated intravascular coagulation and right lower limb gangrene that required amputation of all five toes and surgical debridement of the metatarsals. The usual etiology of hypernatremic dehydration in this age group is insufficient breast milk intake. Here, the infant's mother was treated for bipolar disorder with lamotrigine 250 mg orally once daily, aripiprazole 15 mg orally once daily, and sertraline 100 mg orally once daily.
Conclusions: Awareness of these complications should prompt close follow-up of the infant with poor weight gain. The role of maternal medication as a risk factor for hypernatremic dehydration among exclusively breastfed infants needs to be further explored." [Résumé de l'auteur]
in Breastfeeding Medicine > Vol. 12, n°6 (Juillet - Août 2017) . - pp. 377-380[article]Vol. 34, n°3 - Août 2018 - Special Issue: Social Justice and Lactation (Bulletin de Journal of Human Lactation)