Table 77 Lactation Risk Categories
| Category | Medications and Mothers’ Milk 2019 |
|---|---|
| L1 | Compatible (safest)Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant. Controlled studies in breastfeeding women fail to demonstrate a risk to the infant and the possibility of harm to the breastfeeding infant is remote; or the product is not orally bioavailable in an infant |
| L2 | Probably compatible (safer)Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant; And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding women is remote |
| L3 | Probably compatible (moderately safe)Here are no controlled studies in breastfeeding women, however the risk of untoward effects to a breasfed infant is possible, or controlled studies show only minimal non‐threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant (New medications that have absolutely no published data are automatically categorized in this category, regardless of how safe they may be) |
| L4 | Potentially hazardous (possibly hazardous)There is positive evidence of risk to a breastfed infant or to breastmilk production, but the benefits of use in breastfeeding mothers may be acceptable despite the risk to the infant (e.g., if the drug is needed in a life‐threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective) |
| L5 | Hazardous (contraindicated)Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience, or it is a medication that has a high risk of causing significant damage to an infant. The risk of using the drug in breastfeeding women clearly outweighs any possible benefit from breastfeeding. THe drug is contraindicated in women who are breastfeeding an infant |
From: Hale TW. Hale’s Medication & Mothers’ MilkTM 2019, 18th edn. Springer 2019. 998 Republished with permission of Springer Publishing Company, permission conveyed through Copyright Clearance Center, Inc.