Drug Transport Into Milk

  • Patrick J. McNamara
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 501)


The advantages of breast-feeding for both mother (maternal-infant bonding, cost savings, reduced risk of premenopausal breast cancer, etc.) and for the infant (bactericidal effects of lysozyme, presence of immunoglobulins, more readily digested, decrease in food allergy, lower incidence of obesity and morbidity, etc.) are compelling and ensure the favorable view of this form of infant nutrition. These benefits of human milk have prompted an increasing number of health care workers to encourage mothers to breast-feed. Often these nursing mothers are also taking medications and raise this issue as a concern. Most medications pose little serious risk to the infant; however, this concern cannot always be addressed with certainty since the extent of passage into milk has not been studied for most drugs. Moreover, their pharmacokinetic and pharmacodynamic fate in the very young have not been examined.


Salicylic Acid Food Allergy Human Milk Ergot Alkaloid Premenopausal Breast Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. [AAP] American Academy of Pediatrics. AAP issues policy statement on the transfer of drugs and other chemicals into human milk. American Academy of Pediatrics. Am Fam Physician 1994a;49(6):1527–1529.Google Scholar
  2. [AAP] American Academy of Pediatrics, Committee on Drugs. The transfer of drugs and other chemicals into human milk [see comments]. Pediatrics 1994b;93:137–150.Google Scholar
  3. Aranda JV, Cook CE, Gorman WCnllingeJM, Loughnan PM, Outerbridge EW, Aldridge A, Neims AH. Pharmacokinetic profile of caffeine in the premature newborn infant with apnea. J Pediatr 1979; 94:663–668.PubMedCrossRefGoogle Scholar
  4. Atkinson HC, Begg EJ. Prediction of drug concentrations in human skim milk from plasma protein binding and acid-base characteristics. Br J Clin Pharmacol 1988a;25:495–503.CrossRefGoogle Scholar
  5. Atkinson HC, Begg EJ. Relationship between human milk lipid-ultrafiltrate and octanol-water partition coefficients. J Pharm Sci 1988b;77:796–798.CrossRefGoogle Scholar
  6. Atkinson HC, Begg EJ. Prediction of drug distribution into human milk from physicochemical characteristics. Clin Pharmacokinet 1990;18:151–167.PubMedCrossRefGoogle Scholar
  7. Atkinson HC, Begg EJ, Darlow BA. Drugs in human milk. Clinical pharmacokinetic considerations. Clin Pharmacokinet 1988;14:217–40.PubMedCrossRefGoogle Scholar
  8. Begg EJ, Atkinson HC. Modelling of the passage of drugs into milk. Pharmacol Ther 1993;59:301–310.PubMedCrossRefGoogle Scholar
  9. Begg EJ, Atkinson HC, Duffull SB. Prospective evaluation of a model for the prediction of milk: plasma drug concentrations from physicochemical characteristics. Br J Clin Pharmacol 1992;33:501–505.PubMedCrossRefGoogle Scholar
  10. Fleishaker JC, McNamara PJ. In vivo evaluation in the lactating rabbit of a model for xenobiotic distribution into breast milk. J Pharmacol Exp Ther 1988;244:925–928.PubMedGoogle Scholar
  11. Kari FW, Weaver R, Neville MC. Active transport of nitrofurantoin across the mammary epithelium in vivo. J Pharmacol Exp Ther 1997;280:664–668.PubMedGoogle Scholar
  12. McNamara PJ, Burgio D, Yoo SD. Pharmacokinetics of acetaminophen, antipyrine, and salicylic acid in the lactating and nursing rabbit, with model predictions of milk to serum concentration ratios and neonatal dose. Environ Health Perspect 1991;91:63–70.CrossRefGoogle Scholar
  13. Neville MC, Walsh CT. Effects of xenobiotics on milk secretion and composition. Am J Clin Nutr 1995;61(3 Suppl):687S–694S.PubMedGoogle Scholar
  14. Oo CY, Kuhn RJ, Desai N, Wright CE, McNamara PJ. Pharmacokinetics in lactating women: prediction of alprazolam transfer into milk. Br J Clin Pharmacol I995a;40:23l-236.Google Scholar
  15. Oo CY, Kuhn RJ, Desai N, McNamara PJ. Active transport of cimetidine into human milk. Clin Pharmacol Ther 1995b;58:548–555.CrossRefGoogle Scholar
  16. Oo CY, Burgio DE, Kuhn RC, Desai N, McNamara PJ. Pharmacokinetics of caffeine and its demethylated metabolites in lactation: predictions of milk to serum concentration ratios. Pharm Res 1995c; 12:313–316.CrossRefGoogle Scholar
  17. Pons G, Rey E, Richard MO, Vauzelle F, Francoual C, Moran C, d’Athis P, Badoual J, Olive G. Nitrofurantoin excretion in human milk. Biol Neonate 1990;57:367–374.CrossRefGoogle Scholar
  18. Toddywalla VS, Kari FW, Neville MC. Active transport of nitrofurantoin across a mouse mammary epithelial monolayer. J Pharmacol Exp Ther 1997;280:669–676.PubMedGoogle Scholar
  19. Wilson JT. Determinants and consequences of drug excretion in breast milk. Drug Metab Rev 1983; 14:619–652.PubMedCrossRefGoogle Scholar
  20. Wilson JT. Transfer of drugs and other chemicals into human milk. Pediatrics 1990;86:149–150.PubMedGoogle Scholar
  21. Wilson JT. Drug exposure via breastmilk. Pharmacokinetics and Pharmacodynamic in the Developing Newborn, Little Rock AR; 1996.Google Scholar
  22. Wilson JT, Brown RD, Hinson JL, Dailey JW. Pharmacokinetic pitfalls in the estimation of the breast milk/plasma ratio for drugs. Annu Rev Pharmacol Toxicol 1985;25:667–689.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Patrick J. McNamara
    • 1
  1. 1.College of PharmacyUniversity of KentuckyLexingtonUSA

Personalised recommendations