Hi Jessica,



You asked, "In regards to the Perinatal Care Core Measure on Exclusive Breast Milk Feeding one of the exceptions to exclusive breastfeeding is taking certain medications. There is a small list of medications but there is no resource guide to all the medications or who rates the medications as contradictive such as AAP/Dr. Hale. Does anyone know where the list or what reference they use? "



Sorry, I don't know the answer, but I would assume that any usually acceptable reference could be used, as you named above. I think even the pediatrician, for example, could give reasons in which he felt a certain drug would be contraindicated for a particular baby, say with a high bilirubin level some sulfa drugs I believe could be contraindicated. Our nursery discharge orders have a place where the dr. checks a box "exclusive bf -- yes or no" -- and reason. We recently had one where the dr. counseled against bf and he checked "maternal medication contraindicated" (or something like that) -- marijuana (L5). Hale was used as a reference.



This was a regular user of marijuana, and we counseled her about using, and based on info from the Infant Risk Center it was advised that she pump and dump 5 half-lives from the last time she used, which was 12.5 days, so the doc told her 2 wks. Hope this helps.



Laurie Wheeler RN MN IBCLC

Mississippi USA





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