SPS Breastfeeding resources

SPS produces Medicines specific advice during breastfeeding which we would always advise checking first and which should give directive answers.

It includes advice on individual medicines, therapeutic groups or more detailed information on our most frequently asked questions.

In the majority of cases, this will provide you with all the information you need as we have based our advice on evidence taken from multiple sources.

If the information is not available on the SPS website, or your clinical scenario is complex, we would suggest you seek further advice from your regional MI centre or UKDILAS

You can also read more about how we put our content together.

Our top 3 additional suggestions

In addition to our own resources, we particularly recommend the following:

NHS website: Medicines A-Z

The NHS Website: Medicines A-Z provides:

• We particularly recommend this for patients and for patient-facing material
• It contains information for patients on a wide range of commonly used medicines, including over the counter medicines
• Each webpage for an individual medicine has a section on pregnancy and breastfeeding in patient-friendly language

Medicines Learning Portal

The Medicines Learning Portal provides clinical problem-solving training:

• We recommend this to support the training of the pharmacy team
• It contains a tutorial on breastfeeding written in conjunction with UKDILAS.

GP Infant Feeding Network

The GP Infant Feeding Network supports quality improvement in the field of infant feeding:

• We recommend this to find out more about best practice in healthy infant feeding in general, including breastfeeding
• It gives practical advice on feeding related issues, e.g. mastitis, candida infection, vitamin D supplementation

Other products you may find useful

If you find yourself answering a lot of enquiries about medicine use in breastfeeding, you may find these additional resources helpful:

NICE Clinical Knowledge Summaries

• NICE Clinical Knowledge Summaries (CKS) include some guidelines advising on the management of conditions in breastfeeding mothers and
• There is also a specific guideline on breastfeeding problems

Electronic Medicines Compendium

• The Electronic Medicines Compendium (eMC)  contains Summaries of Product Characteristics (SmPCs) and Patient Information Leaflets (PILs)
• This information clarifies the licensed status of a medicine’s use during breastfeeding and is not clinical advice. Manufacturers generally take a very cautious approach because of a lack of data
• These should not be used as a sole information source for these types of medicines-related question

BNF

• The BNF statements on use of medicines during breastfeeding are brief and may be based largely on SmPC statements.
• As such, the information is generally over cautious and gives little additional guidance over and above the SmPC

BNF for Children

• In some circumstances it may be helpful to check the BNF for Children to see if the medicine can itself be used in neonates or infants as this provides reassurance of use in the paediatric population

Unicef Baby Friendly Initiative

• The Unicef Baby Friendly Initiative contains an interesting evidence section and advice on breastfeeding support in general

LactMed

• Lactmed is part of the US National Library of Medicine website
• It is considered a reputable and up to date resource although not all medicines are included
• Provides information on whether the medicine affects the lactation process itself

e-lactancia

• e-lactancia is a Spanish website with an English version provided
• Wide coverage of products with succinct entries including a lactation risk category. Some monographs have short additional notes
• Suitable alternatives are given where available

Medications and Mothers’ Milk (Hale)

• Hale is considered a reputable and up to date US reference source
• It is particularly useful for breastfeeding related pharmacokinetics
• It does require a subscription