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Antihistaminics and other compounds are used as antiemetics. Very rarely, mild restlessness, sedation or weak sucking - none of which require treatment - have been described in the breastfed infant (see, for example, Moretti 1995).

There is no detailed knowledge regarding the effects during breastfeeding of the following substances: betahistine, cinnarizine, dimenhydrinate, diphenhydramine, flunarizine, meclizine, and scopolamine patches, nor of the newer serotonin-(5-HT3) antagonists dolasetron, granisetron, ondansetron, palonosetron, and tropisetron.

The brief half-life of 2-3 hours and the long effectiveness of up to 24 hours argue for good tolerance of meclizine during pregnancy. Metoclopramide is discussed in section 4.3.3. For phenothiazine neuroleptics and sulpiride, see Chapter 4.9.

Recommendation. The antiemetic of choice during breastfeeding is meclizine. Even with the other, older antiemetics, including the phenoth-iazine-neuroleptics which are used for this purpose, severe intolerance in the infant - especially after single dosages - would not be expected.

If a serotonin antagonist such as ondansetron is indicated during lactation, the child should be observed for unexpected symptoms.

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New Mothers Guide to Breast Feeding

New Mothers Guide to Breast Feeding

For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.

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