Breastfeeding Interruption and Resumption: A Risk-Based Clinical Decision Framework
- 1Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- 2Department of Obstetrics and Gynecology, Cuza Voda Hospital, 700038 Iasi, Romania
Abstract
Lactating women often need medication, contrast-enhanced or nuclear imaging, or treatment for infection, and each raises the question of whether breastfeeding can continue. Advice is frequently binary, and in some settings interruption may be recommended more readily than the evidence warrants. This narrative review proposes that breastfeeding interruption be managed as a clinical decision with three linked components: whether interruption is necessary, its minimum necessary duration and the criterion for resumption. We distinguish the hazard of an agent, the infant’s actual exposure and the resulting clinical risk, and apply a common sequence of questions to maternal pharmacotherapy, contrast media, radiopharmaceuticals and selected maternal infections, using pharmacokinetic, dosimetric or transmission measures. The evidence base remains limited and heterogeneous: in a major lactation database, 54% of listed medications had no breastfeeding safety data, and no direct measurement of contrast-media absorption in breastfed infants was identified. The proposed framework grades management across five levels, from unrestricted breastfeeding to avoidance or definitive cessation; whether a restriction is temporary or definitive follows the applicable guidance, and resumption criteria are defined at the outset. This conceptual aid is not a validated decision rule, does not replace agent-, procedure-, radionuclide- or pathogen-specific guidance and requires prospective evaluation.
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BibTeX
@article{petroaie2026breastfeeding,
title = {{Breastfeeding Interruption and Resumption: A Risk-Based Clinical Decision Framework}},
author = {Antoneta Dacia Petroaie and Alexandru Carauleanu and Iustina Petra Solomon Condriuc and Eric Oliviu Cosovanu and Elena Teona Cosovanu and Oana Raluca Temneanu and Ana Maria Slanina and Elena Popa and Adorata Elena Coman},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208148},
url = {https://www.mdpi.com/2077-0383/15/20/8148},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Breastfeeding Interruption and Resumption: A Risk-Based Clinical Decision Framework
AU - Antoneta Dacia Petroaie
AU - Alexandru Carauleanu
AU - Iustina Petra Solomon Condriuc
AU - Eric Oliviu Cosovanu
AU - Elena Teona Cosovanu
AU - Oana Raluca Temneanu
AU - Ana Maria Slanina
AU - Elena Popa
AU - Adorata Elena Coman
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208148
UR - https://www.mdpi.com/2077-0383/15/20/8148
AB - Lactating women often need medication, contrast-enhanced or nuclear imaging, or treatment for infection, and each raises the question of whether breastfeeding can continue. Advice is frequently binary, and in some settings interruption may be recommended more readily than the evidence warrants. This narrative review proposes that breastfeeding interruption be managed as a clinical decision with three linked components: whether interruption is necessary, its minimum necessary duration and the criterion for resumption. We distinguish the hazard of an agent, the infant’s actual exposure and the resulting clinical risk, and apply a common sequence of questions to maternal pharmacotherapy, contrast media, radiopharmaceuticals and selected maternal infections, using pharmacokinetic, dosimetric or transmission measures. The evidence base remains limited and heterogeneous: in a major lactation database, 54% of listed medications had no breastfeeding safety data, and no direct measurement of contrast-media absorption in breastfed infants was identified. The proposed framework grades management across five levels, from unrestricted breastfeeding to avoidance or definitive cessation; whether a restriction is temporary or definitive follows the applicable guidance, and resumption criteria are defined at the outset. This conceptual aid is not a validated decision rule, does not replace agent-, procedure-, radionuclide- or pathogen-specific guidance and requires prospective evaluation.
SN - 2077-0383
ER -