Drugs and Breast Milk
Abstract
The recent publication of the Committee on Drugs of the American Academy of Pediatrics1 of an updated list of drugs and their potential effect on the infant or lactation is most welcome, given the increase both in the practice of breast-feeding and the awareness of the medical and lay public as to the adverse effect of drugs ingested by the nursing mother. In particular, the availability of newer antihypertensive and psychoactive agents for the treatment of common postpartum conditions inevitably leads to therapeutic dilemmas for the perinatal team concerned about the maternal-infant dyad.
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Atenolol may lead to symptoms consistent with beta-adrenergic blockage in neonates.
“The selective b-1 adrenergic receptor-blocking agent atenolol should not be used in breastfeeding mothers because it may lead to symptoms consistent with b-adrenergic blockage in neonates.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [515]
The adverse effect of atenolol in neonates presumably develops because atenolol is <5% bound to maternal plasma proteins (vs 93% binding of propranolol), and thus accumulates in milk, and because of low kidney excretion of atenolol in small children with immature renal function.
“This adverse effect presumably develops because atenolol is <5% bound to maternal plasma proteins (vs.93% binding of propranolol), and thus accumulates in milk, and because of low kidney excretion of atenolol in small children with immature renal function (515).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [515]
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Ross, D. S., Burch, H. B., Cooper, D. S., Greenlee, M. C., Laurberg, P., Maia, A. L., Rivkees, S. A., Samuels, M., Sosa, J. A., Stan, M. N., et al. (2016) · Thyroid® · doi:10.1089/thy.2016.0229 · Cited by 2,938 · see citing works
Nutrient Requirements For Preterm Infant Formulas
Klein, C. J. (2002) · Journal of Nutrition · doi:10.1093/jn/132.6.1395s · Cited by 381 · see citing works
“Committee on Drugs, 1994; Anderson, 1995; Berlin, 1995; Eidelman & Schimmel, 1995; Schanler & Butte, 1997).”
Safety of medications in special population
Al‐Worafi, Y. M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-819837-7.00013-3 · Cited by 375 · see citing works
Ohya, Y., Arakawa, K., Arata, N., Arima, S., Arima, H., Asayama, K., Dohi, Y., Fukami, A., Furuhashi, M., Goto, K., et al. (2026) · Hypertension Research · doi:10.1038/s41440-025-02462-y · Cited by 81 · see citing works
Nice, F. J., DeEugenio, D. L., DiMino, T. A., Freeny, I. C., Rovnack, M. B., & Gromelski, J. S. (2004) · Journal of Pharmacy Technology · doi:10.1177/875512250402000304 · Cited by 5 · see citing works
Nice, F. J., DeEugenio, D. L., DiMino, T. A., et al. (2004) · Journal of Pharmacy Technology · doi:10.1177/875512250402000205 · Cited by 5 · see citing works
Thyroid Disorders During Pregnancy, Postpartum, and Lactation
Quandt, Z., Salmeen, K. E., & Block-Kurbisch, I. J. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-814823-5.00019-2 · Cited by 1 · see citing works
- Authors
- Eidelman, A. I., & Schimmel, M. S.
- Affiliations
- Shaare Zedek Medical Center (IL)
- ORCID
- Eidelman, Arthur I.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 1995-06-01
- Volume
- 95
- Issue
- 6
- Pages
- 956-957
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1553730455
- Cited by
- 7
- References
- 0
- Citations by year
- 2026: 1 · 2020: 1 · 2019: 1 · 2016: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- drug safety in lactation, breastfeeding, lactating women, infant drug exposure, antihypertensive drugs, psychoactive substances
- MeSH terms
- Atenolol, Breast Feeding, Central Nervous System, Clomipramine, Female, Humans, Imipramine, Infant, Infant, Newborn, Male, Milk, Human
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