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There is a considerable lack of understanding concerning the effects of xenobiotics on lactational physiology, lactational neuroendocrinology, and the behavioral component of parent–infant bonding
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Parental pain, anger, confusion, and/or frustration are associated with a reduction in the normal pulsatile frequency of oxytocin and a 30%–50% reduction of milk volume per nursing episode
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The major neurotransmitters affecting lactation include dopamine D2, serotonin 5-HT2A, and/or serotonin 5-HT1A receptors
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Common psychotropic medications affect these neurotransmitter pathways and have been shown to impact the triad including:
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Antipsychotics (e.g., phenothiazines that target the neurohormones associated with oxytocinergic pathways)
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Antidepressants (e.g., serotonin receptor uptake inhibitors [SSRIs] that delay secretory activation in lactating parents)
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Recommendations for the use of these drugs in breastfeeding parents have not been formulated
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Recreational drugs (e.g., tobacco, alcohol, cannabis)
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Environmental toxins (e.g., endocrine disrupting chemicals [EDCs]) -
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Exposure to EDCs is associated with the dysfunction of hormone-mediated processes such as metabolism, energy balance, thyroid and reproductive functions, immune functions, and neurodevelopment
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A myriad of bioactive components of plant- or animal-source foods have been found in human milk. While the potential impact of some of these compounds have been studied in parents and infants, their implications for the biology of human milk have not been studied
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Numerous environmental toxins have also been found in human milk. While their potential impact on human health has been examined, their implications for human milk biology have not been examined
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Alcohol and the active ingredients in tobacco (nicotine) and cannabis (THC) are found after parental consumption in human milk and are transferred to infants
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The presence of these substances may affect infant’s taste preferences and may have long-term implications for feeding behavior
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While there is evidence of the impact of these exposures on infant feeding, sleep, and other behaviors, it is difficult to determine the direct cause and effect due to the confounding impacts of drug exposure on parental neuroendocrinology and behavior
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