title: [Breast-feeding (part IV): Therapeutic uses, dietetic and addictions--guidelines for clinical practice].
abstract: OBJECTIVE
  To describe the practical aspects of the use of the most commonly prescribed drugs during the postpartum period, the dietetic measures and the management of breast-feeding in case of addictive behaviors.
  
  
  METHODS
  Review of the literature between 1972 and May 2015 from the databases Medline, Google Scholar, Cochrane Library, and international recommendations of learned societies.
  
  
  RESULTS
  The precaution to stop breast-feeding when drugs are necessary is not justified in many situations (professional consensus). Aspirin at antiaggregant dose is allowed during breast-feeding while high doses are not recommended; NSAIDs with short half-life can be used (professional consensus). Precautions are needed in cases of use of morphonics (professional consensus). There is no justification to delay the initiation of breast-feeding in case of locoregional or general analgesia or for caesarean section. Antibiotic treatment does not justify discontinuing breast-feeding (professional consensus). Anxiolytics of the class of antihistaminic sedating H1 such as hydroxyzine (Atarax®) should not be prescribed in case of breast-feeding (professional consensus). Imaging does not justify to stop breast-feeding (professional consensus). Tobacco consumption is discouraged but is not a contraindication to breast-feed (professional consensus). It is recommended to avoid the consumption of alcohol (professional consensus). In case of occasional and moderate consumption of alcohol, delaying breast-feeding for a minimum of two hours is recommended (professional consensus). Cocaine consumption is a contraindication of breast-feeding (professional agreement), and breast-feeding is not recommended in case of cannabis use (professional consensus).
  
  
  CONCLUSIONS
  Few drug treatments are not compatible with breast-feeding that can be continued in most of the cases.
authors.affiliation: Service de gynécologie-obstétrique II et médecine de la reproduction, Port-Royal hôpital Cochin, université Paris Descartes, Assistance publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France. Electronic address: louis.marcellin@cch.aphp.fr.
authors.forename: L
authors.initials: L
authors.lastname: Marcellin
authors.affiliation: Inserm UMR 1153, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), centre de recherche épidémiologie et statistique Sorbonne Paris Cité, DHU risques et grossesse, université Paris Descartes, 75014 Paris, France; École de sages-femmes Baudelocque, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 75014 Paris, France.
authors.forename: A A
authors.initials: AA
authors.lastname: Chantry
mesh_terms: D001942:Breast Feeding / Q000379:methods; D004046:Dietetics / Q000592:standards; D004358:Drug Therapy / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D049590:Postpartum Period / Q000502:physiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011247:Pregnancy; D019966:Substance-Related Disorders / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D004364:Pharmaceutical Preparations
keywords: Allaitement; Breast-feeding; Dietetic; Diététique; Drogues; Drugs; Medication; Médicaments; Therapeutics use