Home Clinical Medicines in breast milk

Medicines in breast milk

Clinical

April 11, 2018

Pharmacists can provide advice to breastfeeding women on using medicines that are compatible with breastfeeding and on how to minimise infant exposure to medicines via breast milk.

Learning objectives

After reading this article, pharmacists should be able to:

Discuss with consumers the safe use of medicines in breastfeeding
Identify factors that influence an infant’s exposure to a medicine in breast milk
Explain the pharmacist’s role in advising consumers of strategies to minimise infant exposure to medicines in breast milk.

Competencies (2016) addressed: 1.1.2, 1.13, 1.5.1, 2.3.1, 2.4.1, 3.2.5, 3.5.2, 5.3.4.

Competencies (2010) addressed: 1.2.1, 1.5.2, 2.1.1, 2.1.3, 2.3.3, 4.3.3, 6.2.2, 7.1.4, 7.3.2, 7.3.3, 8.1.4.

Case scenario

Angela, a young mum of four-month-old Harriet, comes to the pharmacy with a prescription for Panadeine Forte (paracetamol 500 mg, codeine phosphate hemihydrate 30 mg), prescribed as two tablets taken up to six-hourly as needed.

Angela has significant pain after badly spraining her ankle when she tripped and fell while jogging. She asks if she can safely take the medicine while breastfeeding Harriet. How would you respond?

Want to learn more? PSA members can access the full article and assessment questions here to earn up to 1.5 Group 2 CPD credits.

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ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?

Why do you feel this is such a pivotal moment for PSA and the profession?

What are the major challenges pharmacists are facing right now?

How do you see the profession evolving in 5 years?

How have your background and previous experiences shaped your views of the profession?

Case scenario

Learning objectives

Introduction

Aetiology and pathophysiology

Clinical features

Diagnosis, differential diagnosis and prognosis

Management and treatment

Knowledge to practice

Conclusion

Case scenario continued

Key points

References

Our authors

Our reviewer

Conflict of interest declaration

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?

Why do you feel this is such a pivotal moment for PSA and the profession?

What are the major challenges pharmacists are facing right now?

How do you see the profession evolving in 5 years?

How have your background and previous experiences shaped your views of the profession?

Case scenario

Learning objectives

Introduction

Aetiology and pathophysiology

Clinical features

Diagnosis, differential diagnosis and prognosis

Management and treatment

Knowledge to practice

Conclusion

Case scenario continued

Key points

References

Our authors

Our reviewer

Conflict of interest declaration

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?