围麻醉期哺乳对婴儿影响的新进展

Research advances on effect of perianesthetic breastfeeding to infant

背景哺乳期妇女接受麻醉及外科手术治疗后，由于担心母乳中的药物成分可能给婴儿带来不利影响，经常会导致哺乳期妇女不适当停止哺乳。目的综述围麻醉期哺乳对婴儿影响的最新认识。内容婴儿摄取药物的剂量受母体血药浓度、药物半衰期、摄入母乳量、婴儿体重等因素影响。药物种类对婴儿影响也很大，可划分为绝对安全、比较安全、中等安全、相对危险和禁止使用5类。对于早产儿或其他抵抗力低下的婴儿，因药物清除率降低，需要重视对这些孩子母亲调整用药剂量，个体化评价利与弊。列举国际上对围麻醉期常用药物最新的安全性分级。趋向总体上讲，母乳中的药物含量如在治疗量范围内，早期哺乳带来的综合影响利大于弊。

Background The breastfeeding mother may need anesthesia and surgery. The lack of reliable information on drug effects taken by breastfeeding mothers on their breastfed infants often leads to inappropriately discontinuing breastfeeding by motherswho experienced surgery.Objective To review research progresses on effects of perianesthetic breastfeeding to infant.Content The nursing infant′s drug exposure is influenced by the drug concentration in maternal serum at the time of feeding, half-life period of drugs, the amount of breast milk ingested by the infant, and the infant′s weight. Drugs are classified five levels based on their safety for nursing infants： safest, safer, moderately safe, possible hazardous and contraindicated. Mothers of premature or other otherwise compromised infants may need altered dosing to avoid drug toxicity in these infants with decreased clearance and individually evaluate the effects of breastfeeding to infants. At last, we listed the latest safety grading commonly used drugs.Trend In general, the benefits of breastfeeding outweigh the risk of exposure to most therapeutic anesthesia agents via human milk.