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EP11: Pharmacotherapeutics and Lactation

Medications and breastfeeding: most drugs are compatible, with minimal transfer into breastmilk so many lactating women can continue treatment safely

IBCLCs responsibilities in pharmacotherapeutics during pregnancy and breastfeeding requires knowledge of principles of drug transfer into breastmilk, and core concepts of pharmacokinetics, pharmacodynamics, quality use of medicines, conventional and complementary drug groups, highlighting safe medication use while protecting breastfeeding.

Course Learning Outcomes

  1. Critically analyse pharmacokinetic principles and drug properties to evaluate mechanisms of medication transfer into breastmilk and predict infant exposure levels.
  2. Critically evaluate maternal medication regimens to inform evidence-based risk-benefit assessments and develop safe prescribing recommendations during lactation.
  3. Investigate antibiotics, contraceptives, and analgesics to inform evidence-based prescribing decisions that optimise maternal health and minimise infant exposure.
  4. Critically assess galactagogue efficacy and safety to develop evidence-based recommendations regarding appropriate use, dosing protocols, and monitoring strategies.
  5. Critically evaluate complementary and alternative medicines to inform evidence-based risk-benefit assessments and support shared decision-making during lactation.

IBLCE® Detailed Content Outline

Every module maps directly to the IBLCE® Detailed Content Outline, building your knowledge progressively from foundational science through to clinical application.

This course covers the following IBLCE® DCO items. The applicable Lactation (L), Ethics (E) and Related (R) hours are shown against each heading.

1. Alcohol
2. Nicotine and tobacco
3. Cannabis
4. Medications (e.g., prescriptions, over-the-counter, diagnostic and therapeutic procedures, aids to labor and delivery)
5. Drugs of abuse
6. Contraception
7. Galactagogues
8. Gel dressings/nipple creams
9. Herbs and supplements
10. Chemotherapy/radiation therapy/radioactive scans
A. Equipment and Technology
B. Education and Communication
C. Ethical and Legal Issues
D. Research
E. Public Health and Advocacy
A. Equipment and Technology
1. Feeding devices (e.g., tubes at breast, cups, syringes, teats, paladai)
2. Handling and storage of human milk
3. Nipple devices (e.g., shields, everters)
4. Dummies (pacifiers)
5. Pumps
6. Scales (e.g., accuracy, precision, operation)
7. Communication technology (e.g., virtual visits, translation or interpretation services, websites)
B. Education and Communication
1. Active listening
2. Anticipatory guidance
3. Care plan development and sharing
4. Educating mothers and families
5. Educating professionals, peers, and students
6. Emotional support
7. Empowerment
8. Group support
C. Ethical and Legal Issues
1. Breastfeeding in public
2. Clinical competencies
3. Code of Professional Conduct (CPC)
4. Principles of confidentiality
5. WHO code - advocacy and policy
D. Research
1. Apply evidence-based practice
2. Interpret research results
3. Use research to help develop policies and protocols
4. Design research (including gaining ethical permission)
5. Participate in surveys and data collection
E. Public Health and Advocacy
1. Advocate for Baby-Friendly Hospital Initiative (BFHI)
2. Advocate for compliance with World Health Organization International Code of Marketing of Breast-milk Substitutes (WHO Code)
3. Advocate for mother / infant in healthcare system
4. Develop breastfeeding-related policies
5. Advocate to government / health ministries
6. Breastfeeding in emergency situations (e.g., natural disasters, personal emergencies)

Course Content

Welcome
Recommended textbooks
Handbook - Pharmacotherapeutics and Lactation
Additional Resources
Module Learning Outcomes - Foundational Principles
Introduction
Professional Parameters
Pharmacotherapeutics Overview
#1 Quiz - Professional Parameters & Pharmacotherapeutics
Self Directed Learning Activity - Practitioners and Women's Knowledge and Attitudes
#2 Quiz - Practitioners and Women's Knowledge and Attitudes
Self Directed Learning Activity - Shared Decision-Making
#3 Quiz - Shared Decision-Making
Module Learning Outcomes - Conventional Drug Therapy
Introduction
Drug Transfer Into Breastmilk
#4 Quiz - Drug Transfer Into Breastmilk
Self Directed Learning Activity - Antibiotics and Lactation
#5 Quiz - Antibiotics and Lactation
Self Directed Learning activity - Galactagogues
#6 Quiz - Galactagogues
Self Directed Learning Activity - Analgesics and Opioids
#7 Quiz - Analgesics and Opioids
Self Directed Learning Activity - Contraception
#8 Quiz - Contraception
Self Directed Learning Activity - Miscellaneous Drugs
#9 Quiz - Miscellaneous Drugs
Module Learning Outcomes - Non-Conventional Medicines
Introduction
Complementary Medicines and Breastfeeding
Lifestyle, Drugs and Breastfeeding
#10 Quiz - Complementary Medicines, Lifestyle, Drugs and Breastfeeding
Self Directed Learning Activity - Complementary Medicines
#11 Quiz - Complementary Medicines
Self Directed Learning Activity - Galactagogues
#12 Quiz - Galactagogues
Self Directed Learning Activity - Substance Misuse and Abuse
#13 Quiz - Substance Misuse and Abuse
#14 Holistic Quiz