{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:00:36Z","timestamp":1787238036015,"version":"build-2736575974"},"reference-count":40,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The National Lactation Study Center was established by Ruth Lawrence, MD, in 1981 to offer consultations on complex breastfeeding and lactation issues. In 2018, a REDCap\u00ae database was developed to track cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective, observational review of cases from June 2018 to December 2024. We report frequencies of exposures (medication and toxin), along with geographic area, provider type, and lactation concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We recorded 4,965 consultations (4,791 exposures and 174 breastfeeding management encounters). There were 4,941 cases from 44 states (United States), and 24 cases from other countries. Most occurred by telephone (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 3,394; 71%), with fewer by email (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 1,522; 28%). There were 4,049 (82%) from providers and 916 cases (18%) from consumers\/patients. Of these, lactation consultants were the primary users (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 2,915; 72%), with physicians accounting for 14% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 578). There were 10,435 total medications reviewed, with most cases involving \u22642 medications (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 6,395; 61%). Drugs with central nervous system (CNS) activity accounted for the largest portion of queries (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 5,389; 52%). Most lactation management cases were primarily maternal-side concerns such as low milk supply or oversupply (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 116; 85%), fewer were primarily infant concerns, such as rare metabolic and cardiac conditions (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 21; 15%), and questions related to human milk, including milk storage and properties (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17; 11%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Inquiries regarding medications with CNS activity were the most prevalent. Of management concerns, most were related to low or oversupply of milk. The use of this service reflects an ongoing need for information on medication use and complex concerns in lactation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253251380549","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T13:33:05Z","timestamp":1758202385000},"page":"818-826","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Seven Years of Breastfeeding Consultations at the National Lactation Study Center\u2014June 2018 to December 2024"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3839-8766","authenticated-orcid":false,"given":"Rogelio","family":"Perez-D\u2019Gregorio","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4539-3587","authenticated-orcid":false,"given":"Casey B.","family":"Rosen-Carole","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA."},{"name":"Department of Pediatrics, University of Rochester, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuo","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Burtner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA."},{"name":"Department of Pediatrics, University of Rochester, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-2312","authenticated-orcid":false,"given":"Sandra H.","family":"Jee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Rochester, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, USA."},{"name":"Department of Pediatrics, University of Rochester, Rochester, New York, USA."},{"name":"Department of Environmental Medicine, University of Rochester, Rochester, New York, USA."},{"name":"Department of Pathology and Clinical Laboratory Medicine, Rochester, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Breastfeeding: A Guide for the Medical Profession","author":"Lawrence R","year":"2021","unstructured":"Lawrence R, , Lawrence R., editors. 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New York; 2024; p. 303.","edition":"21"},{"key":"e_1_3_4_17_2","unstructured":"Drugs and Lactation Database (LactMed\u00ae). Hydromorphone. NICH and HD: Bethesda MD; 2006. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501227\/ [Last accessed: June17 2025]."},{"key":"e_1_3_4_18_2","first-page":"629","volume-title":"Hale\u2019s Medications & Mother\u2019s Milk 2025\u20132026. A Manual of Lactation Pharmacology","author":"Hale TW","year":"2024","unstructured":"Hale TW, , Krutsch K. Zolpidem tartrate. In: Hale\u2019s Medications & Mother\u2019s Milk 2025\u20132026. A Manual of Lactation Pharmacology, 21st ed. (Hale TW, , Krutsch K. eds). Springer Publishing Company LLC. New York; 2024; p. 629.","edition":"21"},{"key":"e_1_3_4_19_2","unstructured":"Drugs and Lactation Database (LactMed\u00ae). Zolpidem tartrate. NICH and HD: Bethesda MD; 2006. 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