Abstract: briggs drugs in pregnacy and pregnancy and lactation food and drug administration enhancing student learning of drugs in pregnancy and cardiac medications in pregnancy and lactation medications in pregnancy and lactation university of iceland medications in pregnancy / lactation drugs in pregnancy, lactation, for postpartum patients on drugs during pregnancy and lactation drugs in pregnancy jordan university of science and safe lists for medications in pregnancy: inadequate book review: drugs during pregnancy and lactation prescribing for pregnancy and lactation ahn drug use during pregnancy and lactation a pharmacy continuing education program use of antihypertensive drugs during pregnancy and lactation drugs in pregnancy & lactation ispatula pregnancy and lactation keep pregnancy, lactation, and reproductive potential: labeling medications in pregnancy and lactation drugs contrandicated in pregnancy jordan university of pregnancy and prescription drug abuse drugs pregnancy lactation reference guide jfnott antirheumatic drugs in pregnancy and lactation drugs in pregnancy and lactation angelfire drugs pregnancy lactation reference guide unirak new fda pregnancy and lactation labelling requirements drugs in pregnancy and lactation: a reference guide to drugs pregnancy lactation reference guide bizday medications in pregnancy and lactation world scientific drug use in pregnancy & lactation imcd drug safety: pregnancy rating classifications and medications and more during pregnancy and breastfeeding psychotropic medication in pregnancy/lactation drugs in pregnancy and lactation ispatula fda implements new labeling for medications used during exposure to psychotropic medications and other substances over-the-counter medications in pregnancy prescribing in pregnancy and lactation book drugs pregnancy lactation reference guide comprehensive point of care drug facts & comparisons safety of drugs during pregnancy and breastfeeding in psychotropic drugs in pregnancy and lactation w À ] safe drugs during pregnancy and lactation chemotherapeutic drugs in pregnancy treatment of tachyarrhythmias during pregnancy and lactation herbal medicines and pregnancy jptcp treatise published in the journal of small animal practice

Abstract: For an evaluation of the effects of heat stress during pregnancy on calf birth weight and postpartum maternal milk yield, 21 cows and 10 heifers were assigned to shade (S; n = 16) or no shade (NS; n = 15) treatments during the last trimester of pregnancy in June 1978. At parturition, all cows were removed from treatment and uniformly managed in the milking herd. At 4-d intervals from d 199 of pregnancy to parturition, respiration rates, rectal temperature, heart rate and Black Globe temperature were recorded and blood samples obtained via tail venipuncture between 1300 and 1600 h. Weekly prepartum body weights of dam, birth weight of calf and subsequent daily milk yield were recorded. Black Globe temperature, rectal temperature and respiration rates were higher in cows given NS. Calf birth weight was lower in the NS group. Milk yield was correlated in a linear manner with calf birth weight, and cows in group NS exhibited reduced lactation performance after calving. Plasma progestin concentrations were higher in heat-stressed cows (6.0 vs 5.1 ng/ml). Estrone-sulfate concentrations were reduced in plasma of NS cows (2,505 vs 4,433 pg/ml). Thus, hormone concentrations of maternal and fetal origin were altered by environment. Plasma thyroxine concentrations were lower in NS cows (51.2 vs 66.4 ng/ml), while plasma triiodothyronine concentrations were elevated (1.8 vs 1.5 ng/ml), indicating altered thyroid hormone metabolism in heat-stressed cows. Heat stress altered endocrine dynamics during pregnancy and reduced calf birth weight and may have indirectly altered subsequent milk yield.

Abstract: The composition of human milk from mothers delivering prematurely (PT) and at term (T) was studied over the first weeks of lactation. Complete 24 h milk expressions were obtained by electric pump at weekly or biweekly intervals through 44 wk conceptual age (120 samples from 20 PT mothers and 28 samples from 7 T mothers). PT milk was found to contain significantly higher concentrations than T milk of the following nutrients: total nitrogen, protein nitrogen, sodium, chloride, magnesium and iron. No differences were found between T and PT milk for nonprotein nitrogen, volume, solids, total calories, lactose, fat, fatty acids, potassium or calcium. The nutrients supplied to a 33 wk preterm infant fed 200 ml/kg/day of "average" PT milk were in excess of theoretic intrauterine requirements for all substrates except calcium and phosphorus. PT human milk is theoretically more suitable for the premature infant than either mature or term human milk, but may be deficient in specific nutrients for the very low birth weight baby.

Abstract: Milk samples were collected from 10 mothers by a standardised technique with complete expression of both breasts at each feed for 24 hours. Samples were obtained at 8 intervals during the first 36 days of lactation. Analyses were performed for trichloroacetic acid-precipitable protein, total protein, lactose, triglycerides, phospholipids, cholesterol, energy, sodium, potassium, calcium, magnesium, zinc, copper, pH, and osmolality. The results give a comprehensive picture of the development of milk composition from transitional to mature milk. The most striking feature of the results was the high degree of variation observed both between samples from the same mother and between samples from different mothers on the same day of lactation.

Abstract: There is no doubt that in breast-feeding women, suckling with its associated hyperprolactinaemia prevents the resumption of ovarian activity for prolonged periods (see McNeilly, 1979) The extent of this suppression varies greatly among species but in all for which there are adequate data it appears to depend critically upon the intensity of the suckling stimulus (Lamming, 1978) Our recent data from women show that in the pattern of suckling, frequency and duration, throughout the day, are both key factors in maintaining the elevation of basal levels of prolactin associated with lactation (McNeilly, Howie & Houston, 1980a; Howie & McNeilly, 1982) Suckling also releases large quantities of prolactin, maintaining a physiological hyperprolactinaemic state which is directly associated with the duration of lactational amenorrhoea (Delvoye, Badawi, Demaegd & Robyn, 1978; Duchen & McNeilly, 1980) The question remains, how does suckling suppress ovarian activity? The levels of prolactin in blood during peak lactation appear to be many times the requirement for production of milk It therefore becomes pertinent to ask whether this prolactin is released solely to stimulate milk production or whether it is involved directly in the suppression of ovarian activity If there is a direct involvement then there are two loci for this action; an effect at the hypothalamic-pituitary level or a direct effect on the ovary While the former has received some attention (see McNeilly, 1979, 1980a), relatively little information is available (for species other than the rat) on whether or how prolactin might act on the ovary and, in particular, how high levels might interfere or block follicular development during lactation (McNeilly, 1980b) The purpose of this paper is to review the evidence for a direct action of prolactin on the ovary in the context of the effects of prolactin in the control of normal ovarian cyclicity

Abstract: 1. The deposition of fat during pregnancy and its subsequent mobilization during lactation was studied in the rat. The utilization of protein during lactation was also investigated. 2. Fat accumulation was rapid and continuous from early pregnancy. Approximately one-third was deposited subcutaneously, the remainder being stored in central depots. 3. The volume of milk produced during lactation was varied by offering protein at two concentrations from day 2 post partum. Optimum lactation was achieved with a high-protein diet. The dams lost no body protein, but 60% of the total body fat was mobilized, despite a marked increase in food consumption. On a low-protein diet, food intake did not rise during lactation. Some body protein was catabolized and, again, 60% of the fat was mobilized although milk output, as judged by the gain in carcass energy of their pups, was reduced to approximately one-third of optimum. 4. Protein was used more efficiently by lactating rats, when compared with virgin controls. 5. We conclude that fat stored during pregnancy makes a major contribution to the energy costs of lactation, and that its mobilization is under hormonal rather than dietary control.

Abstract: Milk production was measured in fourteen Quarter Horse mares at seven stages of a 150-d lactation period. Mares were divided into two groups of seven and fed diets containing either soybean meal or soybean meal and urea as nitrogen supplements. Rations were isocaloric, contained approximately 12.5% crude protein and were fortified with vitamins and minerals. Daily milk yield was estimated by the weigh-suckle-weigh method and milk composition was determined from samples taken by hand milking. Average daily milk yield ranged from 11.8 kg in early lactation to 9.8 kg in late lactation. Differences (P less than .01) in milk yield due to number of previous lactations were observed. Also, diet influenced (P less than .01) milk yield, with mares fed soybean meal producing an average of 1.2 kg more milk/d than mares fed urea as part of the N supplement. Further, stage (day) of lactation influenced (P less than .01) daily milk yield. The largest mean daily milk yield was measured at approximately 30 d postpartum, but the predicted lactation curve was linear (P less than .05) over the range of observations in this study. Average percentages of total solids, protein and fat over the 150-d lactation were 10.5, 2.1, and 1.3, respectively. All components decreased significantly with advancing lactation. There was a trend toward a positive association between milk yield and solids content of the milk, but it was not significant. Milk yield was not significantly related to fat content of the milk. However, milk yield and protein content were correlated (r = .23; p less than .05). As expected, solids content of the milk was positively associated with percentages of protein (r = .59; P less than .01) and fat (r = .44; P less than .01). Relationships among milk components were similar after adjustment for days in milk. However, yield of milk and composition were unassociated (P less than .05) when days in milk were held constant.

Abstract: Two 9-week-old, breast-fed premature infants developed acrodermatitis and hypozincemia because of low zinc content in their mothers' breast milk. All symptoms of zinc deficiency disappeared within seven days after the infants were treated orally with zinc and did not recur when zinc was discontinued after 11 months (infant 1) and three weeks (infant 3). After a subsequent term pregnancy, one of the mothers had lower breast milk zinc content (P less than .025) and greater exponential decline (P less than .025) of zinc content through 40 weeks of lactation compared with 34 control subjects. Her second infant (infant 2) had hypozincemia at 7 months of age but did not develop clinical zinc deficiency. When the mothers of the affected infants took oral zinc supplements, there was no increase in their breast milk zinc content. Zinc secretion into breast milk appears to be a controlled process that is independent of maternal zinc intake or serum zinc level. Breast milk may be low in zinc because of defective mammary secretion and this may lead to severe symptomatic zinc deficiency in premature infants.

Abstract: To further identify and characterize the nitrogen fraction of human milk, nucleotide and total nitrogen contents were determined using high pressure liquid chromatography and Kjeldahl analyses. Five lactating women were followed longitudinally. Each provided 16 milk samples (8-10 ml each) collected before and after a single nursing, and in the morning and afternoon of a single day. This collection scheme was followed at 2, 4, 8, and 12 wk postpartum. The variance pattern of nucleotides was observed to be distinct from that of total nitrogen. As the lactation period progressed from wk 2 to 12 postpartum, levels of cytidine 5' monophosphate and adenosine 5' monophosphate declined from 594 to 321 micrograms/100 ml and from 244 to 143 micrograms/100 ml, respectively, whereas levels of inosine 5' monophosphate increased from 158 to 290 micrograms/100 ml and levels of total nucleotide nitrogen remained constant. Nucleotide nitrogen accounted for approximately 0.1-0.15% of the total nitrogen content of human milk samples analyzed. Total concentration of human milk was observed to decrease as lactation progressed and to be higher in afternoon than in morning samples. The nucleotide profile of human milk was characteristically different from that of other milks commonly used an infant feeding. It is estimated that an infant consuming human milk as a principal nutrition source would ingest 1.4-2.1 mg of nucleotide nitrogen per day.

Abstract: A continuous cell line (HBL-100) was obtained from primary cultures of cells derived from an early lactation sample of human milk. There was no evidence of a breast lesion in the milk donor. Karyotype analysis showed that all metaphases contained human chromosomes including a large acrocentric marker chromosome. Both desmosomes and cytoplasmic tonofibrils were observed during early passage. HBL-100 cells exhibited several characteristics of transformation including the ability to form colonies in soft agar, an aneuploid chromosome complement, and continuous growth.

Abstract: Two experiments were carried out to measure effects of body condition at calving and different levels of feeding after calving on milk and subsequent reproduction.In experiment 1, which was conducted in two consecutive years, 162 cows (77 in year 1 and 85 in year 2) were group feed so as to reach a target body condition (condition scores ranging from 3-6) four weeks before calving. During the last four weeks before calving, all cows were managed so as to maintain their individual condition scores. At calving, cows in similar condition of similar breed and with similar previous milk production were allocated to high and low levels of feeding at pasture for the first five weeks of lactation. Mean pasture intakes were 13.0 and 7.0kg dry matter (DM)/cow.d in year 1 and 15.0 and 8.5 kg DM/cow.d in year 2In experiment 2, 40 cows were offered pasture and hay from 20 weeks before calving to achieve a body condition score of either 4 or 6 by two weeks before calving. During the first five weeks of lactation, cows were individually fed in stalls on freshly cut pasture at one of three levels of intake, 7 or 10 kg DM/cow.d or .In both experiments cows were grazed as one group from week 6 to 20 of lactation.Improved body condition at calving resulted in an extra 4.0, 11.0 and 7.4 kg milk fat per unit condition score over 20 weeks of lactation, for year 1 and 2 of experiment 1, and experiment 2, respectively. Cows in poorer condition partitioned a higher proportion of feed energy to liveweight at the expense of milk production than did the cows in better condition. However, increasing the plane of nutrition in early lactation resulted in higher levels of milk production and reduced the need for cows to mobilize bodyreserves. Improved body condition at calving had a positive effect on milk fat percentage, particularly in early lactation, but did not affect milk protein percentage. Input-output relations calculated from the experimental data showed that the benefit sf to improve body condition before calving was less than that of additional feeding after calvin changes in the condition of the cows were taken into consideration (25.8 vs 1 4.6 kg DM to yi kilogram of milkfat). Improvements in condition and feeding in early lactation reduced the anoestrus interval after calving by 5.7 d for each additional condition score at calving and 1. d for each additional kgDM/cow.d fed over weeks 1-5 of lactation. The input-output relations resented will enable farmers to assess the likely consequenes of changes in their feeding management in the crucial peripartum period with a greater degree of confidence than in the past.

Abstract: Samples of milk from 23 mothers attending the department of obstetrics and gynaecology and 36 who donated milk to the department9s milk bank were cultured for cytomegalovirus. Virus was isolated from samples from 12 of the milk donors but none of the mothers attending the department; follow-up studies during lactation in seven of these 12 women showed that five continued to excrete the virus. Samples were taken on three occasions from one woman who regularly excreted high titres of the virus. Storage at -20 degrees C for over three days reduced the titre by over 99%; after pasteurisation at 63 degrees C for eight minutes the milk did not contain any viable virus. It is recommended that raw banked milk used for feeding preterm babies should be kept frozen for at least 72 hours before feeding.

Abstract: The acid-soluble ribonucleotides of human milk were measured by enzymic and ion-exchange chromatographic procedures at different stages of lactation. Human colostrum and milk contained CMP, AMP, GMP, UMP, GDP-mannose, UDP-N-acetyl-glucosamine, UDP-N-acetyl-galactosamine, UDP-glucose, UDP-galactose, UDP and other minor nucleotides. Cytidine and adenosine derivatives were present in relatively higher amounts than in milk from ruminant species. The nucleotide concentration decreased with advancing lactation. Human milk at 3 months of lactation contained about 10 µmol/100 ml nucleotides, which represented about 75% of the amount of nucleotides present in human colostrum. Human milk did not contain orotic acid. The UDP-glucose/UDP-galactose ratio was constant during lactation and was similar to that of milks from ruminant species.

Abstract: Evidence is presented to support the postulates that increases in apparent maintenance requirements during pregnancy and lactation are due, in part, to increases in relative weights and metabolic activities of vital organs. Rates of glucose, palmitate and pyruvate oxidation per unit weight in vitro were one-and-a-half to three times greater in liver, heart and intestine samples from pregnant and lactating as compared to nonlactating rats. Relative weights of liver, intestinal tract and heart were greater in lactating as compared to nonlactating rats. Weights of liver, heart and intestines are functions of feed intake and may parallel a previously reported logistic function which relates feed intake to apparent maintenance requirements. A theoretical calculation indicated that an increase in maintenance requirements from 100 kcal metabolizable energy/kilograms075 to 124 kcal metabolizable energy/kilograms0 '5 during lactation in rats could be explained on the basis of changes in the relative weights of liver, intestines and heart. J. Nutr. 112: 1876-1880, 1982.

Abstract: PIP: Current approaches to infant feeding have been based on the level of available knowledge of nutritional requirements of full term and low birth weight (LBW) infants and on established cultural traditions in many contemporary societies. This discussion summarizes existing information about infant nutrition and immunobiologic aspects of human milk, which may influence the choice of breast versus bottle feeding of infants in different parts of the world. The average caloric requirement for a normal full term infant from the 2nd day of age through the 1st year of life is estimated to be about 100-110 Kcal/kg/day. Caloric intake of less than 80 Kcal/kg/day is usually insufficient for physiologic needs and intakes over the average requirement may be associated with obesity. The minimum requirement for protien has been estimated to be about 1.8 gm/100 Kcal and protein intake of over 4.5 gm/100 Kcal may result in an increased urea nitrogen retention. The nutritional requirements of premature and LBW infants have not been clearly established, but the nutritional needs of a LBW infant appear to be significantly higher than the requirements of a normal full term infant. The chemical composition of human milk exhibits considerable variation between different individuals and in the same individual at different times of lactation, as well as between samples obtained from mothers of LBW infants and full term infants. Fresh milk contains a wealth of components that provide specific and nonspecific defenses against infectious agents or other macromolecules. The concentrations of protein, whey protein nitrogen, sodium and potassium in cow's milk are 2-3 times higher than in human milk. Only limited information is available about the spectrum of environmental chemical and toxins present in cow's milk. The composition of human milk meets the minimum requirements for protein and calories for a growing full term infant, despite the fact that protein content of pooled human milk is low (0.9 gm/ml). Breastfeeding seems to result in a more balanced solute load because breastfed babies appear to require less water than babies fed on cow's milk. Commercial formula products often require reconstitution and supplementation with certain additives during manufacture or at the time of its feeding to the infant. Careful, but sparse epidemiologic studies conducted recently in several rural and urban settings, demonstrated a striking resistance of breastfed infants to colonization by coliform organisms. In modern times possibly the single most important consideration for the use of breastfeeding is its cost. Infants fed human milk do not grow as rapidly as those fed most commercial formulas, but there is no evidence to suggest that rapid growth is a desirable goal of nutrition for normal neonates. Conclusive evidence of overwhelming nutritional advantages of human nilk and breastfeeding over commercial milk products (which are properly reconstituted under sterile conditions) is not available at this time.

Abstract: The effect of vitamin D on bone changes during the reproductive cycle in female rats has been investigated. One group of female rats was maintained on a vitamin D-deficient diet and another group of a vitamin D-replete diet from weaning. Both groups were mated with normal males and changes in their bones were determined histomorphometrically during pregnancy, lactation, and after weaning. All vitamin D-deficient rats had bone changes typical of rickets. Pregnancy caused significant reductions in mineralized tissue of trabecular and cortical bone in the vitamin D-deficient rats. Lactation caused further significant reductions in mineralized tissues of cortical and trabecular bone in both the vitamin D-deficient and vitamin D-replete animals, with the greatest changes seen at weaning. Some restoration of mineralized tissues occurred following weaning. There was an increase in tetracycline-labeled bone surface in the vitamin D-replete animals during lactation, likely due to an increase in bone formation rates. In the vitamin D-deficient animals during lactation, there was a decrease in tetracycline-labeled bone surface, likely due to severely depressed bone mineralization. These results indicate that the mobilization of calcium from bone to maintain pregnancy and lactation occurs by a mechanism independent of vitamin D.

Abstract: To determine the mechanisms responsible for the suppression of follicular development in the lactating rat, in vivo and in vitro determinations of steroid and peptide hormones combined with the histological size-distribution of ovarian follicles were compared among three groups of post-parturient rats nursing 0, 2 or 8 pups. From Days 4 to 12 (day of parturition = Day 0 of lactation), in dams nursing 8 pups, follicles larger than 401 microns in diameter were absent, whereas follicles of this size were always present in mothers nursing 0 or 2 pups. The in vitro production rates of estradiol-17 beta (E2) and testosterone (T) by nonluteal ovarian tissues (NLO) were consistently lower in dams nursing 8 pups than in mothers nursing 0 or 2 young, correlating with the histological observations. Serum E2 and 20 alpha-dihydroprogesterone (20 alpha-OHP) in rats with 8 pups were significantly lower, whereas serum progesterone (P) was significantly increased compared to the values in dams nursing 0 or 2 pups. In mothers nursing 8 pups, the corpora lutea (CL) of lactation, formed at postpartum ovulation, produced in vitro significantly greater amounts of P but significantly lesser amount of E2 compared to the other groups. Serum luteinizing hormone (LH) was consistently lower in dams nursing 8 pups than in dams nursing 0 or 2 pups. There was, however, no significant difference in serum follicle-stimulating hormone (FSH) among the 3 types of postparturient rats. Throughout lactation serum values of FSH were within the range of diestrous levels during the estrous cycle. Serum levels of prolactin (Prl) in dams nursing 8 pups were strikingly higher compared to dams nursing 2 pups. The administration of small doses of human chorionic gonadotropin (hCG) or ovine LH twice daily from Days 2 to 5 to lactating rats nursing 8 pups induced the maturation of follicles capable of ovulating. These findings indicate that during the first half of lactation the strong suckling stimulus reduces serum LH directly or indirectly via high levels of serum Prl and P, which in turn inhibit follicular maturation. During the second half of lactation, the suckling stimulus wanes, Prl and P decline and serum LH recovers to basal cyclic values which are reflected in the initiation of follicular maturation.

Abstract: Four trials were conducted with a total of 188 crossbred sows to determine the effect of feeding diets supplemented with tallow (0 or 8%) and choline chloride (220 or 770 mg/kg diet) prior to parturition and during lactation on preweaning pig performance. On d 100 of gestation, sows were allotted to four factorially arranged dietary treatments: 0% tallow-220 mg/kg choline chloride, 0% tallow-770 mg/kg choline chloride, 8% tallow-220 mg/kg choline chloride, 8% tallow-770 mg/kg choline chloride. Diets without tallow were fed at the rate of 1.82 kg/d with an additional .18 kg/d of cornstarch, whereas sows receiving diets supplemented with tallow were fed 1.82 kg/d. Daily metabolizable energy intake was constant for all diets (approximately 6,240 kcal). Following parturition, the diets were fed ad libitum for a 21-d lactation period. Pig survival to 21 d, in relation to the number of pigs born alive/litter, did not differ significantly between litters from sows receiving tallow (94.0%) and litters from sows receiving the control diet (92.5%). Although not significantly different, there was a trend toward slightly heavier pigs (6.35 vs 6.11 kg) and litters (53.97 vs 51.94 kg) after the 21-d lactation period in the groups nursing sows receiving tallow-supplemented diets. Litter performance was not improved by the addition of choline to sows' diets. A second study was conducted to measure the effect of energy source on milk yield and composition. Twelve crossbred sows was allotted to two dietary treatments (0 and 8% tallow), each supplemented with 770 mg choline chloride/kg of diet. The composition of colostrum and milk was determined on d 0, 9 and 18, and milk yield was measured on d 12 and 19. Throughout the lactation period, sows fed the tallow supplemented diet produced higher concentrations of total milk solids (22.15%, P less than .10) and fat (14.9%, P less than .01) than the control group (21.37 and 12.0%, respectively). Milk protein content, averaged over the lactation period, was lower (P less than .10) for sows receiving tallow (8.60 vs 9.22%); however, the depression appeared to be related to the colostrum samples, because values for the two treatment groups were similar on d 9 and 18. The mean milk yield was 9.44 kg/d for sows receiving tallow and 8.72 kg/d for those fed the control diet. Therefore, not only did sows in the tallow group produce a greater concentration of milk solids and fat, but the total quantity of the milk constituents available to the offspring was increased.

Abstract: Bromocriptine treatment of lactating rats, or removal of the litter, led to a decrease in the number of insulin receptors in the mammary gland and an increase in the concentration of insulin in the serum. Bromocriptine also induced a decrease in the concentration of both prolactin and progesterone in the serum, whilst concurrent treatment with the former but not the latter prevented all the effects of bromocriptine for 48 h. Removal of the litter produced a similar decrease in the concentration in the serum of prolactin but not of progesterone. Treatment with prolactin prevented all of the effects of removal of the litter for 24 but not 48 h. This suggests that these effects of prolactin may require a mammary gland actually synthesizing milk since the gland rapidly fills with milk after removing the litter whereas milk removal continues to take place in bromocriptine-treated rats allowed to continue nursing their litters.