Drug transfer to human milk after bariatric surgery

[Bianca Balassiano]

Dear Dr. Hale,
I have done a quick research and wasn't able to find information on this topic. Since the digestive system's absorption is impaired after bariatric surgery and some studies suggest that this might affect medications's absorption, how would this impact on the drug transfer to breastmilk of lactating parents that undergo bariatric sugery?
Thank you
Bianca

[kaytlin]

Hi Blanca,

Bariatric surgery does impact the oral absorption of many (but not all) drugs and nutrients. The degree to which oral absorption is affected depends on the type, extent, and location of the surgery. However, this is dependent on the drug, release formulation, and dose. Oftentimes, strategies are used to compensate for the impaired absorption which allows for the patient to still reach therapeutic concentrations post-surgery (for example, a higher dose). The influence of bariatric surgery on drugs in milk will depend on the drug and any compensatory mechanisms used. Overall, if the plasma drug concentration is lower due to impaired absorption the amount in milk will be lower. You just can't expect this will be true for every drug or every type of surgery.

Kaytlin Krutsch, PharmD

[Bianca Balassiano]

Dear Kaytlin, thank you so much for your quick reply!