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Effects of medications and other substances on milk content
Almost all medicines pass into breastmilk in small amounts by a concentration gradient. Some have no effect on the baby and can be used while breastfeeding, while other medications may be harmful to the infant. Women with hypothyroidism may be unable to produce milk. Alcohol use during pregnancy carries a significant risk of serious birth defects, but consuming alcohol after the birth of the infant is considered safe.

Pesticides and other toxic substances bioaccumulate; i.e., creatures higher up the food chain will store more of them in their body fat. This is an issue in particular for the Inuit, whose traditional diet is predominantly meat. Studies are looking at the effects of polychlorinated biphenyls and persistent organic pollutants in the body; the breast milk of Inuit mothers is extraordinarily high in toxic compounds.

Effects of medications and other substances on milk content[edit]
Almost all medicines pass into breastmilk in small amounts by a concentration gradient. The amount of drug bound by maternal plasma proteins, the size of the drug molecule, the pH of the drug, and if the drug is lipid soluble or not all determine whether the medication will pass into breastmilk. Medications that are non-protein bound, low in molecular weight, or highly lipid-soluble are more likely to enter the breast milk in larger quantities. Some have no effect on the baby and can be used while breastfeeding,[65] while other medications may be harmful to the infant.

Some generally safe medications that the mother can use while breastfeeding include: On the other hand, there are medications that may be toxic to the baby while breastfeeding, and thus should not be used in breast-feeding mothers, such as: **SHOULD I PUT "A MORE EXTENSIVE LIST CAN BE FOUND AT ______"** https://reader.elsevier.com/reader/sd/pii/S0733862703000373?token=ABB8A8E0CA177D0D9A2B93D7583365CEA31B84691A2ACA7516F06C68AAF3938357C30A0E85782EC3A92E288E16AD323B

Furthermore, drugs of abuse, such as cocaine, amphetamines, heroin, and marijuana cause adverse effects on the infant during breastfeeding. Adverse effects include seizures, tremors, restlessness, and diarrhea.

To reduce infant exposure to medications used by the mother, use topical therapy or avoid taking the medication during breastfeeding times when possible.[1]

There are some medications that will decrease the amount of breast milk produced…..

Alternatively, there are some medications that may stimulate the production of breast milk. These medications may be beneficial in cases where women with hypothyroidism may be unable to produce milk.[66][67] A Cochrane review looked at the drug domperidone (10 mg three times per day) with results showing significant increase in volume of milk produced over a period of one to two weeks. Another review stated low evidence that use of Domperidone and Metoclopramide to enhance milk supply works. Instead, non-pharmacological approaches such as support and more frequent breastfeeding may be more efficacious. --> MAYBE ADD THIS TO THE PRODUCTION SECTION

Finally, there are other substances besides medications that may appear in breast milk. Alcohol use during pregnancy carries a significant risk of serious birth defects, but consuming alcohol after the birth of the infant is considered safe.[68]

High caffeine intake by breastfeeding mothers may cause their infants to have trouble sleeping or irritability.

A meta-analysis has shown that breastfeeding mothers who smoke expose their infants to nicotine, which may cause respiratory illnesses, including otitis media in the nursing infant.

Pesticides and other toxic substances bioaccumulate; i.e., creatures higher up the food chain will store more of them in their body fat. This is an issue in particular for the Inuit, whose traditional diet is predominantly meat. Studies are looking at the effects of polychlorinated biphenyls and persistent organic pollutants in the body; the breast milk of Inuit mothers is extraordinarily high in toxic compounds.[69]

The CDC has provided some resources for breastfeeding mothers to reference for safe medication use, including LactMed, Mother to Baby, and The InfantRisk Center. **LOOK AT THESE WEBSITES TO SEE IF I CAN ADD MORE TO MY CHARTS**