医生给我开了一张处方。我在用这个药的时候，继续给我的宝宝喂奶是否安全呢？My doctor has prescribed a medication for me. Is it safe for me to continue breastfeeding my baby while I take the medicine?

你在考虑是否应该服用医生给你开的药。如果你已经掌握了哺乳和药物的相关信息，你会很容易地作出决定。母乳喂养对你和你的宝宝来说都是重要的。审慎地研究要服用的药，甚至非处方药。（草药疗法也应该要研究）国际母乳会的《母乳喂养的女性艺术》一书第312页写道：“在为一个哺乳妈妈开药方时，有些医生出于安全，例行公事——坚决要求（患者）断奶。实际上，很少药物被证明对哺乳婴儿是有害的。”突然断奶对母乳妈妈和婴儿都会造成伤害并且导致额外的健康问题和双方的情感危机。你的医疗保健提供者需要知道你正在哺乳并且你想继续哺乳。

You are wondering if you should take the medication that your doctor has prescribed. It‘‘s easier to make that decision when you have information on breastfeeding and medications. Breastfeeding is important to you and your baby. It is prudent to investigate taking any medications, even ones available without a prescription. (Herbal remedies should also be researched.) LLLI WOMANLY ART OF BREASTFEEDING, says on page 312, “When prescribing a medication for a nursing mother, some physicians routinely insist on weaning as a precaution. In reality, few drugs have been proven to be harmful to the nursing infant.” Sudden weaning is traumatic for mother and baby and can lead to additional health and emotional risks for both. Your health care provider needs to know that you are breastfeeding and that you want to continue doing so.

当为哺乳妈妈开药方时要考虑到很多因素。比如，宝宝的年龄需要考虑。一个较大的母乳宝宝，他吃母乳已经不那么频繁了，所吃的母奶量也会小一些，因此通过妈妈的奶吃到的含在母乳里的药也会相应的少一些。以下有一些问题可供你在和你的医疗保健提供者进行会话时使用。（这些问题来源于LEAVEN文章“药物和母乳喂养”）

There are many variables to consider when a breastfeeding mother is prescribed a medication. For example, the baby‘‘s age needs to be taken into consideration. An older baby who is breastfeeding less frequently would consume smaller amounts of breastmilk and thus have less exposure to medication through mother‘‘s milk. Here are some questions to begin a dialogue with your health care provider. (They are from the LEAVEN article “Medications and Breastfeeding”.)

• 这个药物婴儿可以使用吗吗？为母乳妈妈开一种通常能开给婴儿的药一般来说是一种好的选择。
• 这种药曾经给其他的母乳妈妈开过吗？一种曾有母乳妈妈使用史的药比一种新的可能未测试的药是更好的选择。
• 需要使用这个药物多久？使用药物的时间长短会影响其与母乳的兼容性。而一种被认为使用几天能与母乳喂养兼容的药并不一定可以使用较长的时间。
• 是不是短效药？对一位母乳妈妈来说，选择一种短效类型的药比选择一种会停留在母体内较长时间的长效型的药是一种更好的选择。
• 药品如何使用？一种注射的或口服的药比静脉注射的药在体内的浓度要低。然而，一种静脉给以的药或许是因为它是会被消化系统灭活或不被消化系统吸收。所以宝宝的消化系统也会灭活或不吸收该药物，因此使用该药物对宝宝来说是安全的。
• 宝宝对该药物的清除能力如何？有些药物在宝宝的身体内蓄积并能逐渐地达到产生起毒性的水平。一种药物若被宝宝快速清除出体内的药物和母乳喂养更兼容。
• 这种药物妨碍母乳喂养本身吗？母乳妈妈应该避免用一些会影响母乳喂养的药物（比如喷乳反射或产奶量）。

– Has the drug been given to infants? A drug commonly prescribed for infants is usually a good choice for a breastfeeding mother.
– Has the drug been given to other breastfeeding mothers? A drug that has a history of use by breastfeeding mothers is a better choice than a new, possibly untested drug.
– What is the duration of the drug therapy? The duration of the drug therapy can affect its compatibility with breastfeeding. A drug considered compatible with breastfeeding when taken for a few days might not be compatible when taken over a long period of time.
– Is the drug short-acting? A short-acting form of the drug may be a better choice for a breastfeeding mother than a longer-acting form that stays in the mother‘‘s system for a longer period.
– How is the medication being given? A drug given by injection or by mouth is less concentrated than one given intravenously. However, a drug may be given intravenously because it is inactivated or not absorbed by the digestive system, so the baby‘‘s digestive system would also inactivate or not absorb the drug.
– How well can the baby excrete the drug? Some drugs accumulate in a baby‘‘s system and can potentially build to toxic levels. A drug that is quickly eliminated by the baby is more compatible with breastfeeding.
– Does the drug interfere with lactation? Some drugs should be avoided by breastfeeding mothers because they affect breastfeeding itself (the let-down or milk supply).

参考资料：

药物与母乳，Thomas Hale, Ph.D著，每年都校订和更新，这种常见的参考资料是完整的，易于阅读，易于携带。包含药物报告、疫苗、病毒和草药的配制。这些报告包括美国儿科学会推荐的药品，此外，还包含有成人的和儿科的相关药品的副作用的说明。

Resources for Additional Information
Medications and Mothers‘‘ Milk,  by Thomas Hale, Ph.D. Revised and updated every year, this popular reference is complete, easy to read, easily portable, and affordable. Contains reviews of medications, vaccines, viruses, and herbal preparations. The reviews include AAP recommendations as well as adult and pediatric concerns and side effects.

下图是美国卫生部公开建立的针对医护人员的药物与母乳喂养的英文数据库的链接。妈妈们可以将药物的英文名输入搜索，搜索结果包含孕产妇和婴幼儿的用药量，药物对母乳喂养的婴儿及对妈妈泌乳的影响，以及可替代的更安全的药物。建议妈妈们可以将相关信息提供给医生进行参考。