Breastfeeding Resources

Breastfeeding Practice Interest Network (PIN) for Pharmacists

The CPhA Breastfeeding and Infant Nutrition list-serve provides sharing of news, information, upcoming education opportunities, breastfeeding issues, new research on medications in breastmilk, and other topics for pharmacists with a particular interest in the support of breastfeeding families in Canada. The list-serve is open to pharmacists in any specialty area where young families are encountered and opportunities arise to protect, promote and support of breastfeeding. Discussion among members of current issues is encouraged.

In keeping with the World Health Organization International Code of Marketing of Breastmilk Substitutes and Resolutions, the list-serve provides opportunities for pharmacists to share information and discuss the safe and appropriate choice of breastmilk substitutes and ancillary breastfeeding equipment.

The Canadian Pharmacists Association Breastfeeding and Infant Feeding list-serve was started in 2005, ten years after the passing of the CPhA Position Statement on Breastfeeding and Infant Nutrition in 1995. Members of the list-serve are regularly invited to provide updates for the Breastfeeding Resource area of the CPhA website.

Contact Jennifer Peddlesden for more information or to join.

Breastfeeding Resources for Pharmacists

• NEW! Cannabis Use and Breastfeeding
• Breastfeeding Information
• Live and Online Learning on Breastfeeding
• Medications in Breastmilk
• Breastfeeding Policy Statements
• Contact a Breastfeeding Expert
• Breastfeeding Organizations, Networks and Advocacy
• Breast Pump Sales/Rental and Supplementers
• Printed Reference Materials

 Cannabis Use and Breastfeeding

Resources to assist pharmacists and other health proefssionals with questions about cannabis use and breastfeeding.

• Society of Obstetricfians and Gynaecologists of Canada (SOGC) - Statement on cannabis use during pregnancy and breastfeeding and Things you need to know about cannabis, pregnancy and breastfeeding poster
• Motherisk - Marijuana and Breastfeeding and Characteristics of women using marijuana in pregnancy and their reported symptoms of nausea and vomiting of pregnancy: A prospective, controlled cohort study
• Beststart - Risks of Cannabis 
  • En français: Les risques du cannabis
• Montreal Diet Dispensary - During pregnancy, does cannabis consumption carry a risk for the baby?
  • En français: Durant la grossesse, la consommation de cannabis pose-t-elle un risque pour le bébé ?
• Organization of Teratology Information Specialists - Parent Fact Sheets
• RxFiles - General fact sheet on cannabinoid(s), dosing, etc... (Not specific to breastfeeding or pregnancy)
• Betrand K et al. Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk. Pediatrics 2018;142(3)
• Le Prévenant - Consommation de cannabis durant la grossesse et l'allaitement
• Pharmactuel - "Quels sont les risques associés à la consommation de cannabis durant la grossesse et l'allaitement?" Pharmactuel 2018;51(3), Dubé, Pierre-André

Breastfeeding Information

• La Leche League International (LLLI) and La Leche League Canada (LLLC) - Articles on all aspects of breastfeeding for health professionals and the public. All La Leche League materials have been vetted by the La Leche League International Professional Advisory Board.
• Kelly Bonyata BS IBCLC Webpage - Current, evidence- based information on parenting and breastfeeding for parents and professionals. A good place to find information on unusual or unique breastfeeding problems or situations. Moderated by Kelly Bonyata, BS IBCLC.
• The Newman Breastfeeding Clinic & Institute - Dr. Jack Newman’s website offers information for parents and professionals on a wide variety of breastfeeding situations and problems, in particular treatment of candida infections in mother and breastfeeding baby. Information sheets are pdf files and can be printed for clients.
• LACTNET archives - Searchable archives of postings on LACTNET, a list-serve of lactation consultants, midwives and other medical professionals to discuss issues of breastfeeding.

Live and Online Learning on Breastfeeding

• La Leche League Canada Health Professional Seminars
• Health e-Learning - Online breastfeeding education for health care providers; Owned by Dr. Lenore Goldfarb and Carole Dobrich of the International Institute of Human Lactation Inc. based in Montreal, Quebec, Canada. www.health-e-learning.com or 213-261-7605.
• MacEwan University NURS-0191 Issues in Breastfeeding Practice: What Health Care Practitioners Need to Know, is an educational program designed for self-study by health care professionals caring for breastfeeding families. This course is intended to provide current, consistent, factual information in the specialty of human lactation. MacEwan University, Alberta; (780) 497-5040.
• Mohawk College Education on Breastfeeding (distance learning) - This three module program is intended for health professionals and other individuals who educate and support breastfeeding mothers. Mohawk College, Ontario. (905) 575-2703.
• Breastfeeding Course for Health Care Providers and 18 hour Breastfeeding Course (live) - Douglas College, British Columbia. (604) 777-6529.
• Best Start - Best Start is Ontario's Maternal Newborn and Early Child Development Resource Centre and supports service providers working on preconception health, prenatal health and early child development. Click on Breastfeeding.

Medications in Breastmilk

• The Academy of Breastfeeding Medicine (ABM) is a worldwide organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation. Their webpage has a selection of protocols of interest to pharmacists on galactogogues, analgesia, antidepressants, contraception and breastfeeding and the drug dependent woman.
• The Motherisk Clinic at the Toronto Hospital for Sick Children provides reviews and information on medications and breastfeeding for professionals and the public. Motherisk's Home Line (416) 813-6780.
• LactMed - The National Institute of Health National Library of Medicine searchable database on information on drugs and breastfeeding provides the most up-to-date online information on drugs and breastfeeding; type in generic name of medication; analysis and references provided.
• Breastfeeding Pharmacology - Texas Tech University Health Sciences Centre - Webpage moderated by Tom Hale, RPh PhD, author of Medications and Mothers' Milk (see print references) and includes an online forum, discussion of current controversies, an excellent article on how medications enter milk and newsletter.
• Drug Information Centres across Canada. All centres across Canada will have up-to-date books on drugs in breastmilk.
• The IMAGe Centre - Information on Drugs in Pregnancy & Lactation, CHU Sainte-Justine
• The Organization of Teratology Information Specialists (OTIS) - Fact sheets for clients on exposures during pregnancy and lactation.
• The American Academy of Pediatrics - The Transfer of Drugs and Therapeutics into Human Breast Milk; An Update on Selected Topics
• E-lactancia – Search for current information on medications in human milk. It is a project of APILAM, Association for Promotion and Cultural and Scientific Research into Breastfeeding, under a Creative Commons License. Available in Spanish and English.

Breastfeeding Policy Statements/Breastfeeding Initiatives

• Canadian Pharmacists Association Position Statement on Breastfeeding and Infant Nutrition
• Health Canada - Infant Feeding
• Health Canada - Nutrition for healthy term infants, birth to six months: An overview
• College of Family Physicians of Canada Infant Feeding Policy Statement 2004
• American Academy of Pediatrics - Breastfeeding Initiatives (statement on use of human milk, medications and breastfeeding, resources for clients returning to work and breastfeeding, etc.)
• Canadian Paediatric Society (CPS) - Exclusive breastfeeding should continue to six months. Paediatrics & Child Health 2005;10(3):148.
• Canadian Paediatric Society (CPS) - Nutrition for healthy term infants, birth to six months: An overview. Paediatrics & Child Health 2013;18(4):206-7.
• American Academy of Family Physicians - Policy statement on breastfeeding, use of infant formula, and maternal child care, 2012.
• World Health Organization - Global Strategy for Infant and Young Child Feeding - "Sustain exclusive breastfeeding for 6 months and ensure the timely introduction of adequate and safe complementary foods with continued breastfeeding up to two years."
• Public Health Agency of Canada & the Breastfeeding Committee of Canada - Protecting, Promoting and Supporting Breastfeeding: A practical workbook for community-based programs, 2nd ed. - This workbook is intended to assist communitiies to identify strategies and specific actions to protect, promote and support breastfeeding in a population health context. Population health recognizes the social, physical, economic and individual factors that influence a woman’s decision to breastfeed, and her ultimate success with breastfeeding.
• The Baby Friendly Hospital Initiative -- Revised 2018 - On April 11, 2018 WHO and UNICEF issued an updated Ten Step guidance to increase support for breastfeeding in health facilities that provide maternity and newborn services. Breastfeeding all babies for the first 2 years would save the lives of more than 820 000 children under age 5 annually. Step Ten of BFHI now directs engagement of a broader community outside the birthing centre or hospital as essential to support for breastfeeding. This is directed to health professionals, such as pharmacists, outside the hospital or birthing centre. Go here for the 2017 document on evidence for this update. For current Canadian perspective refer to The Breastfeeding Committee for Canada, National Authority for the BFHI.

Contact a Breastfeeding Expert

Canada

• La Leche League Canada
• Canadian Lactation Consultant Association/Association Canadienne des Consultants en Lactation - Find an International Board Certified Lactation Consultant or find out how to become a lactation consultant with the International Board of Lactation Consultant Examiners

Breastfeeding Organizations, Networks and Advocacy

• The Breastfeeding Committee for Canada - National Authority for the WHO UNICEF Baby-Friendly™ Initiative in Canada. (Kelly Coker BScPhm, CPhA Representative on Breastfeeding Committee for Canada: Tel: (705) 765-6254)
• Infant Feeding Action Coalition of Canada (INFACT) - Monitors breastfeeding protection and support in Canada with regard to adherence to the International Code of Marketing of Breastmilk Substitutes 1981, and subsequent relevant World Health Association (WHA) Resolutions.
• International Baby Food Action Network (IBFAN) - This website has a full copy of the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant WHA resolutions pertaining to the Code.

Breast Pump Sales/Rental and Nursing Supplementers

• Ameda pumps and ancillary products from Mother’s Choice Ltd (formerly Hollister) - Complete line of pumps and ancillary products ; 1-800-604-6225.
• Lact-Aid® International, 423-744-9090 - (supplemental nursing system only)

Print Reference Materials

(order through Amazon at www.LLLC.ca)
General Information

• Handouts for clients, information sheets on specific breastfeeding topics, or flyers to promote community breastfeeding support services are available from individual La Leche League Leaders across Canada. Go to La Leche League Canada, www.LLLC.ca, and click on "Find Breastfeeding Help Near You".
• Mohrbacher N. Breastfeeding answers made simple. Amarillo TX: Hale Publishing LP, 2010
• Peddlesden, J. Infant nutrition. Patient Self-Care: Helping patients make therapeutic choices. Ottawa, ON: Canadian Pharmacists Association, 2002. (All aspects of infant nutrition, including artificial baby milks).
• Wiessinger D, West D, Pitman T. The womanly art of breastfeeding. 8^th  revised ed. Schaumburg, Ill: La Leche League International, 2010.

Medications

• Briggs, G., R.Freeman and S. Yaffe. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. 9th edition. Baltimore, ML: Lippincott Williams & Wilkins, 2011. Also available for PDA.
• Hale T. and Rowe H. Medications and Mothers' Milk. 17th ed. Amarillo, TX: Hale Publishing, 2017. This publication is also available as an online edition.
• Centre for Addiction and Mental Health (CAMH). Exposure to Psychotropic Medications and other Substances During Pregnancy and Lactation, A handbook for Health care Providers. Toronto: CAMH, 2007. For copies call 1-800 661-1111 or publications@camh.net.
• Ito S, and Brochet MS. Drug use during breastfeeding. In: The Compendium of Pharmaceuticals and Specialties: the Canadian drug reference for health professionals. Ottawa (ON): CPhA, Drug use during breastfeeding.
• Humphrey, S. The Nursing Mother's Herbal. Minneapolis, MN: Fairview Press, 2003.

Supporting and Protecting Breastfeeding

• Allain A, Yeong JK. Eds. Code Essentials 4: Complying with the International Code of Marketing of Breastmilk Substitutes and subsequent WHA resolutions. Penang, Malaysia; ICDC (International Code Documentation Centre). 2012.
• Allain A, Yeong JK. Protecting Infant Health, a Health Workers' Guide to the International Code of Marketing of Breastmilk Substitutes. 11th ed. Penang, Malaysia: International Baby Food Action Network (IBFAN), 2010.
• Allain A, Yeong JK. Eds. Code Essentials 1: annotated International Code of Marketing of Breastmilk Substitutes and Subsequent WHA resolutions. Penang, Malaysia; ICDC (International Code Documentation Centre), September 2008.
• Allain A, Yeong JK. Eds. Code Essentials 2: Guidelines for Policy Makers on Implementing the International Code of Marketing of Breastmilk Substitutes and Subsequent WHA resolutions. Penang, Malaysia; ICDC (International Code Documentation Centre), February 2009.
• Allain A, Yeong JK. Eds. Code Essentials 3: Responsibilities of Health Workers under the International Code of Marketing of Breastmilk Substitutes and subsequent WHA resolutions. Penang, Malaysia; ICDC (International Code Documentation Centre), March 2009.

This resource list has been compiled by:
Jennifer Peddlesden, BScPharm, IBCLC
Tel/Fax: (403) 272-3764
Please contact Jennifer if you have an information source which you would like to recommend for consideration on this resource list for pharmacists or if you would like more information about the Breastfeeding Practice Information Network.