International Board of Certified Lactation Consultant (IBCLC) Practice Exam

Are the plasma levels of most topical and ophthalmic preparations negligible and unlikely to affect milk levels?

1. Yes

2. No

3. Only certain preparations

4. Depends on dosage

The correct answer is: Yes

The correct answer is that plasma levels of most topical and ophthalmic preparations are indeed negligible and unlikely to affect milk levels. This is based on the pharmacokinetics of these types of medications. Topical preparations, which are applied to the skin, and ophthalmic preparations, which are used in the eyes, generally have minimal systemic absorption. This is because they are designed to act locally at the site of application. When these preparations are applied, only a small amount may enter the bloodstream due to their low permeability through skin and mucosal barriers. Consequently, the quantity that might reach the systemic circulation is typically insufficient to result in a significant concentration in breast milk. As a result, the risk of affecting an infant through breast milk from these types of medications is very low. In contrast, other types of medications, particularly those that are ingested or injected systemically, have a much higher potential to reach significant plasma levels and subsequently influence breast milk composition. The negligible absorption of most topical and ophthalmic medications is a key point in reassuring lactating individuals about the safety of using such products while breastfeeding.