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Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-.
Drug Levels and Effects
Summary of Use during Lactation
There appear to be no contraindications to breastfeeding by mothers who are on dialysis, although there are few reported cases. Analysis of breastmilk indicates that the predialysis milk concentrations of some solutes are abnormal. Authors who managed one patient suggest that breastfeeding after hemodialysis might be preferable to breastfeeding before hemodialysis and milk pumped just before dialysis should be discarded.[1]
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Hyperprolactinemia is a well-known complication of chronic kidney disease.[2-4] Hyperprolactinemia can cause effects such as galactorrhea and hypertension. Dopaminergic agonists such as bromocriptine and cabergoline have been used to counteract these effects.[5,6] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
A mother with end-stage renal disease receiving hemodialysis 3 times weekly partially breastfed her infant for 10 weeks postpartum. Breastmilk samples were collected at various times between day 10 and week 10 postpartum. Sodium and chloride concentrations in breastmilk were higher than in 6 control women without kidney disease, but sodium, chloride, potassium and magnesium in breastmilk were similar pre- and post-dialysis. Phosphate concentration in breastmilk was lower than normal and the mother partially fed her infant with a high-phosphate formula to compensate. Urea, creatinine, and uric acid were higher in breastmilk than in controls, but all were reduced by dialysis; urea levels in breastmilk were normal in post-dialysis samples. Although glucose levels in breastmilk were lower in the patient's milk than in control milk, it was not different pre- and post-dialysis. Protein, triglycerides, cholesterol and immunoglobulins were similar to control milk and were not affected by dialysis. The authors suggest that breastfeeding after a dialysis session is preferable to breastfeeding prior to a dialysis session. They instructed the mother to discard milk pumped immediately prior to dialysis.[1]
References
- 1.
- Balzer MS, Gross MM, Lichtinghagen R, et al. Got milk? Breastfeeding and milk analysis of a mother on chronic hemodialysis. PLoS One. 2015;10:e0143340. [PMC free article: PMC4646653] [PubMed: 26571490]
- 2.
- Cowden EA, Ratcliffe WA, Ratcliffe JG, et al. Hyperprolactinaemia in renal disease. Clin Endocrinol (Oxf). 1978;9:241–8. [PubMed: 709894]
- 3.
- Lim VS, Ferrari E. Hyperprolactinemia in chronic renal failure. Int J Artif Organs. 1981;4:152–3. [PubMed: 7327755]
- 4.
- Carrero JJ, Kyriazis J, Sonmez A, et al. Prolactin levels, endothelial dysfunction, and the risk of cardiovascular events and mortality in patients with CKD. Clin J Am Soc Nephrol. 2012;7:207–15. [PMC free article: PMC3280028] [PubMed: 22193237]
- 5.
- Gulleroglu K, Olgac A, Bayrakci U, et al. Hyperprolactinemia as a rare cause of hypertension in chronic renal failure. Ren Fail. 2012;34:792–4. [PubMed: 22462393]
- 6.
- van Leusen R, Meinders AE. Successful treatment of galactorrhoea during chronic haemodialysis with bromocriptine: A case report. Neth J Med. 1977;20:278–82. [PubMed: 565011]
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Got Milk? Breastfeeding and Milk Analysis of a Mother on Chronic Hemodialysis.[PLoS One. 2015]Got Milk? Breastfeeding and Milk Analysis of a Mother on Chronic Hemodialysis.Balzer MS, Gross MM, Lichtinghagen R, Haller H, Schmitt R. PLoS One. 2015; 10(11):e0143340. Epub 2015 Nov 16.
- Pervasive promotion of breastmilk substitutes in Phnom Penh, Cambodia, and high usage by mothers for infant and young child feeding.[Matern Child Nutr. 2016]Pervasive promotion of breastmilk substitutes in Phnom Penh, Cambodia, and high usage by mothers for infant and young child feeding.Pries AM, Huffman SL, Mengkheang K, Kroeun H, Champeny M, Roberts M, Zehner E. Matern Child Nutr. 2016 Apr; 12 Suppl 2:38-51.
- Mothers' experiences of sharig breastfeeding or breastmilk co-feeding in Australia 1978-2008.[Breastfeed Rev. 2009]Mothers' experiences of sharig breastfeeding or breastmilk co-feeding in Australia 1978-2008.Thorley V. Breastfeed Rev. 2009 Mar; 17(1):9-18.
- Review Medications for increasing milk supply in mothers expressing breastmilk for their preterm hospitalised infants.[Cochrane Database Syst Rev. 2012]Review Medications for increasing milk supply in mothers expressing breastmilk for their preterm hospitalised infants.Donovan TJ, Buchanan K. Cochrane Database Syst Rev. 2012 Mar 14; (3):CD005544. Epub 2012 Mar 14.
- Review Technetium Tc 99m Tilmanocept[Drugs and Lactation Database (...]Review Technetium Tc 99m Tilmanocept. Drugs and Lactation Database (LactMed). 2006
- Dialysis - Drugs and Lactation Database (LactMed)Dialysis - Drugs and Lactation Database (LactMed)
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