Medications and lactation: what PNPs need to know.

The current rise in breastfeeding rates coincides with a continuously expanding prescription medication market. Now more than ever, pediatric nurse practitioners (PNP) are responsible for ordering and consulting on maternal medications during lactation. PNPs are obligated to determine the safety of medications by critically reviewing recommendations that are based on recent clinical research. However, sources vary widely in the relevance of their information. Ideally, comprehensive research-based recommendations about medications and lactation should be based on the pharmacokinetics of drugs in the maternal system, the oral bioavailability of the medication to the infant, and the infant evaluation. Review of the data enables PNPs to effectively evaluate drugs and their actual risks to a breastfeeding infant, thereby supporting integration of sound evidence-based care into clinical practice.