Table 3 Publications on recommendations made by resources on medication use and safety in breastfeeding

10 frequently used sources of information (see Table 4) by US health professionals on medication safety in lactation were evaluated and compared with each other, for 14 commonly used medications (acyclovir, amlodipine, ampicillin, ciprofloxacin, enalapril, haloperidol, metformin, methotrexate, metoprolol, pantoprazole, paroxetine, sertraline) widely recognised as safe, not safe or neither. The number of medications thought to be safe for each source was also assessed.

To determine the reliability of safety recommendations for medications used during lactation, based on current research and information. Also to determine whether resources may be inappropriately advising the interruption of breastfeeding.

Medication and Mothers Milk and LactMed had the highest number of safe-rated medications (12/14 and 11.5/14 respectively) among the sources used, compared with the 2 retail pharmacy databases, Lexi-Comp and the Physician's Desk Reference, which listed the fewest number of safe medications (0.5/14 and 0/14 respectively) and lacked safe listings even for those widely accepted as safe. Of all sources across the sample of 14 medications, LactMed more consistently contained more extensive and current citations, suggesting that it may have been the most reliable source at the time of the study. For medications thought to be unsafe, the 2 retail pharmacy databases gave an alternative recommendation 75% of the time.