How is the breastfeeding risk of neurologic medications determined?

Updated: Aug 20, 2019
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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A classification of the potential effect of medications on breastfeeding infants has been described. [6] This classification is similar to the FDA classification of teratogenicity risk and includes the following categories:

  • Contraindicated

  • Requires temporary cessation of breastfeeding

  • Effect unknown but may be of concern

  • Use with caution

  • Usually compatible

Like the FDA system, this system tends toward a proscriptive approach when no information is available to confirm that breastfeeding is safe. The absence of information results from the understandable exclusion of pregnant or breastfeeding women or of women who may become pregnant from clinical trials. The result may be overly restrictive.

Again, individualized discussions between the woman and her treating physicians may permit informed joint decision-making, during which the benefits of breastfeeding can be considered and balanced against the potential risks of medications excreted in breast milk.

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