The kidneys are the principal organs for excreting water-soluble substances. The biliary system contributes to excretion to the degree that drug is not reabsorbed from the GI tract. Generally, the contribution of intestine, saliva, sweat, breast milk, and lungs to excretion is small, except for exhalation of volatile anesthetics.
Originally published Decemberupdated November and republished with the express permission of the author. Here are answers to some of the most common questions mothers have when facing the possibility or reality of cancer while breastfeeding:. Babies will NOT always refuse to feed from a cancerous breastalthough babies have been known to refuse a breast when the taste of the milk changes or the milk supply decreases due to malignant tissue growth.
This cautious approach may be unnecessary in many cases, because only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants. Few drugs have documented side effects in breastfed infants, and we know most of these. Before you start wondering… "If I take this medication, then pump and dump, is it then safe to breastfeed my baby?
Medically reviewed by Drugs. Last updated on Sep 8, The small amounts of midazolam excreted into breastmilk would not be expected to cause adverse effects in most breastfed infants. Two expert panels advocates waiting for at least 4 hours after a single intravenous dose of midazolam e.
Four nursing mothers consented to anaesthesia for urgent surgery only on condition that their ability to breast feed would not be impaired. After finishing surgery the women could be extubated between and minutes. The women were fully alert just minutes after extubation and spent about 45 minutes in the recovery room before discharge to a regular ward.
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A number of general principles apply when administering analgesic medications for pain management during lactation: 1 the choice of medication should be based on its potential impact on breastfeeding and on the breastfed infant secondary to transfer in human milk; 2 the lowest effective maternal dose is recommended. Breastfeeding is best avoided at times of peak drug concentration in the milk and the infant should be observed of effects of medication transferred in the breast milk. ANZCA, chapter
Concentrations of thiopentone in mature breast milk and colostrum following an induction dose. Acta Anaesthesiol Scand Jan;31 1 Colostrum morphine concentrations during postcesarean intravenous patient-controlled analgesia.