Smoking and Use of Contraindicated Drugs
  • Encourage mothers who smoke to stop smoking and help them to do so. Be sure not to smoke while nursing the baby.

  • If the mother has been using illicit mood-altering drugs, recommendations concerning breastfeeding should be made, on a case-by-case basis, by the health care team.

  • Drugs that are contraindicated during breastfeeding include bromocriptine, cocaine, cyclophosphamide, cyclosporine, doxorubicin, ergotamine, lithium, methotrexate, phencyclidine (PCP), and phenindione (not used in the United States).16

  • Radiopharmaceuticals that require temporary cessation of breastfeeding include gallium-67, indium-111, iodine-125, iodine-131, radioactive sodium, and technetium-99m.16

  • If the mother wishes to breastfeed after treatment with a contraindicated drug is discontinued, assist her with pumping her breasts to maintain lactation and explain why the milk must be discarded.

  • Request consultation concerning safe medically indicated drugs for use when breastfeeding. (See Study Group on Human Lactation and Breastfeeding, under "Examples of Breastfeeding Projects to Assist Health Professionals," Tab 10.)

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