Medicines and breastfeeding

About medicine use

infant feeding ladder Medicine use for breastfeeding women

Health providers and consumers are often unsure about the safety of medicines for breastfeeding women; fear of medicines is increasingly leading women to stop breastfeeding unnecessarily.

Professor Lisa Amir has published a number of articles on this topic, including an open access book chapter (2010). Her most recent article addresses ethical issues around medication and lactation. (See the publications tab on this page). Recent PhD graduate, Dr Moni Rani Saha, is working with Prof Amir, Dr Luke Grzeskowiak (University of Adelaide) and Professor Hedvig Nordeng (University of Oslo) to analyse data from the Norwegian Mother and Baby cohort study, and several papers are in preparation.

Professor Lisa Amir has published an evidence-based guide to use of medicines for breastfeeding women (Amir et al 2011), which is available on the RACGP website.

Professor Lisa Amir is Chief Investigator B on a current multi-centre trial of domperidone for preterm infants led by Dr Grzeskowiak (University of Adelaide) (NHMRC Project Grant APP1165457, 2019-21: $980,000)

Publications

pathway of medicines while breastfeeding

Amir LH, Grzeskowiak LE, Kam RL. Ethical issues in use of medications during lactation. J Hum Lact 2019 (in press). Epub 2019 Nov 26. Available from: https://doi.org/10.1177/0890334419888156

Grzeskowiak L, Amir L, Ingman W. Domperidone can boost breast milk supply – here’s what you need know. The Conversation, 15 March 2018 . https://theconversation.com/domperidone-can-boost-breast-milk-supply-heres-what-you-need-know-88648

Grzeskowiak LE, Amir LH, Smithers LG. Longer-term breastfeeding outcomes associated with domperidone use for lactation differs according to maternal weight. Eur J Clin Pharmacol 2018; 74(8):1071-5. Available from: https://doi.org/10.1007/s00228-018-2470-0

Grzeskowiak LE, Leggett C, Costi L, Roberts CT, Amir LH. Impact of Serotonin Reuptake Inhibitor use on breast milk supply in mothers of preterm infants: a retrospective cohort study. Br J Clin Pharmacol 2018; 84(6):1373-9. Available from: http://dx.doi.org/10.1111/bcp.13575

Grzeskowiak LE, Smithers LG, Amir LH, Grivell RM. Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis. BJOG 2018; 125(11):1371-8. Available from: https://doi.org/10.1111/1471-0528.15177

Blandthorn J, James K, Bowman E, Bonomo Y, Amir LH. Two case studies illustrating a shared decision-making approach to illicit methamphetamine use and breastfeeding. Breastfeed Med 2017; 12(6):381-5. Available from: https://doi.org/10.1089/bfm.2017.0010

Gilmartin CE, Amir LH, Ter M, Grzeskowiak LE. Using domperidone to increase breast milk supply: a clinical practice survey of Australian neonatal units. JPPR 2017; 47(6):426-30. Available from: http://dx.doi.org/10.1002/jppr.1289

de Ponti M, Amir LH, Stewart K, et al. Medicine use and safety whilst breastfeeding: investigating the perspectives of community pharmacists in Australia. Aust J Primary Care 2015;21(1):46-57. Available from: http://dx.doi.org/10.1071/PY13012.

Amir LH, Ryan K, Barnett C. Delphi survey of international pharmacology experts: an attempt to derive international recommendations for use of medicine in breastfeeding women. Breastfeed Med 2015; 10(3):168-74. Available from: http://dx.doi.org/10.1089/bfm.2014.0144

Amir LH. It's time for pharmacists to increase their support for breastfeeding (Editorial). Journal of Pharmacy Practice and Research 2015;45(1):7-8. Available from: http://dx.doi.org/10.1002/jppr.1072.

Grzeskowiak LE, Amir LH. Pharmacological management of low milk supply with domperidone: separating fact from fiction. Med J Aust [Letter] 2015; 202(6):298. Available from: https://dx.doi.org/10.5694/mja14.01585

Grzeskowiak LE, Amir LH. Use of Domperidone to increase breast milk supply: further consideration of the benefit-risk ratio is required. J Hum Lact [Letter] 2015; 31(2):315-6. Available from: http://doi.org/10.1177/0890334414567895

Grzeskowiak LE, Amir LH. Pharmacological management of low milk supply with domperidone: Separating fact from fiction. Med J Aust 2014;201(5):257-58. Available from: http://dx.doi.org/10.5694/mja14.00626.

Amir LH, Ryan KM, Jordan SE. Avoiding risk at what cost? Putting use of medicines for breastfeeding women into perspective. Int Breastfeed J 2012;7:14. Available from: http://dx.doi.org/10.1186/1746-4358-7-14.

McDonald K, Amir LH, Davey M-A. Maternal bodies and medicines: a commentary on risk and decision-making of pregnant and breastfeeding women and health professionals. BMC Public Health 2011;11(Suppl 5):S5. Available from: http://dx.doi.org/10.1186/1471-2458-11-S5-S5.

Amir LH, Pirotta MV, Raval M. Evidence-based guidelines for use of medicines by breastfeeding women. Aust Fam Physician 2011;40(9):684-90.Available from: www.racgp.org.au/afp/201109/44172.

Jayawickrama HS, Amir LH, Pirotta M. GPs' decision making when prescribing for breastfeeding women: Content analysis of a survey. BMC Res Notes 2010;3:82. Available from: http://dx.doi.org/10.1186/1756-0500-3-82.

Amir LH. Medicines for breastfeeding women: risky business? In: Nueland WG, ed. Breastfeeding: Methods, Benefits to the Infant and Mother and Difficulties. Hauppauga, NY: Nova Publishers, 2010:129-41. Available from: https://www.novapublishers.com/catalog/product_info.php?products_id=15585. [open access book chapter]

Amir LH, Pirotta MV. Medicines for breastfeeding women: a postal survey of general practitioners in Victoria, Australia. Melbourne: Mother & Child Health Research, La Trobe University 2010.
Full report [PDF 2.75MB]

Amir LH, Pirotta MV. Medicines for breastfeeding women: a postal survey of general practitioners in Victoria (Letter). Med J Aust 2009;191(2):126. Available from: https://www.mja.com.au/journal/2009/191/2/medicines-breastfeeding-women-postal-survey-general-practitioners-victoria.

Amir LH. Medicines and breastfeeding: information is available on safe use (Letter). Med J Aust 2007;186(9):485. Available from: https://www.mja.com.au/journal/2007/186/11/medicines-and-breastfeeding-information-available-safe-use.