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Review
. 2025 Jun;49(4):152077.
doi: 10.1016/j.semperi.2025.152077. Epub 2025 Apr 2.

Drugs in Lactation

Margarita A P Berwick  1 , Anika J Heuberger  2 , Joimishael V Martin  2 , Thomas W Hale  3 , Adetola F Louis-Jacques  4
Affiliations
Review

Drugs in Lactation

Margarita A P Berwick et al. Semin Perinatol. 2025 Jun.

Abstract

Medication management in lactation is a challenging topic for healthcare practitioners around the world. In contrast to traditional advice, very few medications are now thought to be absolutely contraindicated in breastfeeding. As data from case reports, quantitative studies of medication transfer to milk, and lactation physiology accumulate, fact-based guidance for use of medications can be increasingly provided. This review presents the strengths and weaknesses of current scientific knowledge underlying recommendations for use of medications during breastfeeding, describes key pharmacokinetic factors influencing infant drug exposure in breastmilk, and provides a practical algorithm and case study on use of clinical resources as well as pharmacologic data to help in development of a management plan for lactating individuals with various medication needs.

Keywords: Breastfeeding; Drugs; Infant; Lactation; Management; Medication; Neonate; Safety; Toxicity.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Adetola Louis-Jacques reports financial support was provided by Robert A. Winn Diversity in Clinical Trials Award. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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