Прометазин

1st-generation-antihistamine and phenothiazine-type drug with a strong sedative effect.

At latest update relevant published data on excretion into breast milk were not found.

Pharmacokinetic data (high volume of distribution and high plasma protein-binding capacity) would render it unlikely a significant passage into the breastmilk.

In addition, a low oral bioavailability would hinder a further passage to infant’s plasma through the ingested breastmilk, except on premature infants and immediate neonatal period when there may be an increased intestinal permeability.

It may decrease prolactin levels and interfere with milk production during the first few weeks after birth. ^{(Pontiroli 1981, Messinis 1985)}

It may be considered compatible with breastfeeding on isolated doses such as those used for pre-surgical medication or traveler's dizziness. ^{(WHO 2002)}

Avoid a repeated use as it may cause drowsiness in the infant. Avoid using it in the immediate neonatal period (first 4 to 6 weeks after birth) and in case of prematurity.

There are doubts about any association with Sudden Infant Death Syndrome (SIDS) ^{(Kahn 1982, Stanton 1983)}. If used, follow-up the infant for drowsiness and feeding issues.

Bed-sharing with the baby is not recommended if drugs are used due to increased risk of suffocation or sudden infant death. ^{(ABM 2020 y 2008, UNICEF 2018, 2017, 2014 y 2013, Landa 2012, UNICEF 2006)}