- Only limited data are available on the use of first-generation antipsychotic drugs (FGAs) during lactation.
- Estimates of infant ingestion of FGAs via breast milk vary between 0.1% and 20.7% of the weight adjusted maternal dose.
- When selecting a FGA for use in a breast feeding mother, a less sedating agent with a shorter half-life and data to support use in lactation is preferred.
- Adverse reactions (drowsiness and sedation) in breast fed infants have been reported after exposure to chlorpromazine via breast milk.
- Adverse effects on infant development have been seen only when chlorpromazine was used in combination with haloperidol
- Combined use with other sedating agents is best avoided as this increases the risks of drowsiness and poor feeding in the infant.
- Premature infants should not be exposed to FGAs via breast milk.
- Infants exposed to FGAs via breast milk should be monitored for sedation, poor feeding, behavioural effects, extrapyramidal symptoms and achievement of developmental milestones
Acting Co-Director, West Midlands Medicines Information Service & UK Drugs in Lactation Advisory Service