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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Parenteral Nutrition - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK500786_"><span class="title" itemprop="name">Parenteral Nutrition</span></h1><p class="fm-aai"><a href="#_NBK500786_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 3 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="LM1208.Drug_Levels_and_Effects"><h2 id="_LM1208_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM1208.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Several women receiving either partial or total parenteral nutrition have reportedly breastfed their infants successfully. One prominent group encourages lactation among their patients receiving parenteral nutrition if the mother wishes, with the understanding that formula supplementation may be necessary depending on the adequacy of her milk supply. Infants' growth should be monitored closely as a means of determining adequate nutrition.[<a class="bibr" href="#LM1208.REF.1" rid="LM1208.REF.1">1</a>]</p><p>Intravenous amino acids used alone in postpartum mothers may hasten the onset of lactation and increase weight gain in their breastfed infants.[<a class="bibr" href="#LM1208.REF.2" rid="LM1208.REF.2">2</a>]</p></div><div id="LM1208.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> Relevant published information was not found as of the revision date.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM1208.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>A woman with chronic intestinal pseudo-obstruction was treated with home parenteral nutrition 5 days a week for 5 years at which time she became pregnant. She was maintained on parenteral nutrition during pregnancy and postpartum while she successfully breastfed her infant on the same regimen used during pregnancy.[<a class="bibr" href="#LM1208.REF.3" rid="LM1208.REF.3">3</a>] Twenty months after the first delivery, the mother became pregnant again and delivered a full-term infant by cesarean section. Parenteral nutrition was increased to 7 days a week and she successfully breastfed her second infant with slight modifications in the parenteral nutrition formula.[<a class="bibr" href="#LM1208.REF.4" rid="LM1208.REF.4">4</a>]</p><p>A woman was treated with home parenteral nutrition for 24 years for chronic intestinal pseudo-obstruction. She became pregnant at age 25 and continued with parenteral nutrition that was adjusted as pregnancy progressed. She delivered a preterm infant by cesarean section at 33 weeks gestation and was able to partially breastfeed her infant.[<a class="bibr" href="#LM1208.REF.5" rid="LM1208.REF.5">5</a>]</p><p>A woman with maple syrup urine disease had been treated since birth with special oral formulas low in branched-chain amino acids. She became pregnant and was maintained with oral nutrition until week 37 when partial parenteral nutrition was begun to met increased metabolic demands. Following a cesarean section, the mother successfully breastfed (extent not stated) her infant for over 6 months. Infant growth at 7 months was normal and the Bayley Scales of Infant and Toddler Development Cognitive Composite Score was above average.[<a class="bibr" href="#LM1208.REF.6" rid="LM1208.REF.6">6</a>]</p><p>A 26-year-old woman who was receiving long-term home parenteral nutrition due to short bowel syndrome caused by recurrent thromboembolic mesenteric infarctions. During the third trimester and postpartum, she received only home parenteral nutrition. Following a cesarean section at 37 weeks, she breastfed (extent not stated) her infant. The infant was judged as doing well at 6 months of age and thriving at 1 year of age.[<a class="bibr" href="#LM1208.REF.7" rid="LM1208.REF.7">7</a>]</p></div><div id="LM1208.Effects_on_Lactation_and_Breastmi"><h3>Effects on Lactation and Breastmilk</h3><p>Several case reports exist in which a mother receiving either partial or total parenteral nutrition successfully breastfed an infant.[<a class="bibr" href="#LM1208.REF.1" rid="LM1208.REF.1">1</a>,<a class="bibr" href="#LM1208.REF.3" rid="LM1208.REF.3">3</a>-<a class="bibr" href="#LM1208.REF.8" rid="LM1208.REF.8">8</a>]</p><p>A randomized, controlled, but unblinded study compared lactation onset and duration among women who on the first day postpartum received intravenous infusions of saline (n = 152) daily for 4 days to those who received intravenous amino acids (n = 153) for 4 days (containing isoleucine 5.6 mg, leucine 12.5 mg, lysine hydrochloride 11 mg, methionine 3.5 mg, phenylalanine 9.35 mg, threonine 6.5 mg, tryptophan 1.3 mg, valine 4.5 mg, histidine hydrochloride 8.11 mg, arginine hydrochloride 9.55 mg, alanine 6.2 mg, aspartic acid 3.8 mg, cysteine hydrochloride 1.45 mg, glutamic acid 6.5 mg, proline 3.3 mg, serine 2.2 mg, tyrosine 0.35 mg, glycine 10.7 mg, and xylitol 50.0 mg.) A greater percentage of mothers receiving amino acids achieved lactation onset on the first day postpartum than with saline (86% vs 32%). All mothers in the amino acid group achieved lactation by day 2 postpartum, compared to day 3 postpartum in the saline group. Weight gain in the infants of mothers who received amino acids was greater than thos who received saline at 2 weeks and 1 month of age. Infants in the amino acid group had better sleep than those in the saline group. A quarter of women in the amoino acid group dropped out of the study because of excessive milk production.[<a class="bibr" href="#LM1208.REF.2" rid="LM1208.REF.2">2</a>]</p></div><div id="LM1208.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM1208.REF.1">Rayburn W, Wolk R, Mercer N, et al. Parenteral nutrition in obstetrics and gynecology. <span><span class="ref-journal">Obstet Gynecol Surv. </span>1986;<span class="ref-vol">41</span>:200–14.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/3083312" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3083312</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM1208.REF.2">Nagarathnamma R, Bhushan P, Dutta T, et al. A prospective, randomized, placebo-controlled comparative study of amino acid supplementation in lactation insufficiency. <span><span class="ref-journal">J SAFOG. </span>2020;<span class="ref-vol">12</span>:408–14.</span> [<a href="http://dx.crossref.org/10.5005/jp-journals-10006-1848" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM1208.REF.3">Campo M, Albinana S, García-Burguillo A, et al. Pregnancy in a patient with chronic intestinal pseudo-obstruction on long-term parenteral nutrition. <span><span class="ref-journal">Clin Nutr. </span>2000;<span class="ref-vol">19</span>:455–7.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/11104598" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11104598</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM1208.REF.4">Moreno JM, Gomis P. Pregnancy in a patient with chronic intestinal failure on long-term parenteral nutrition. <span><span class="ref-journal">Clin Nutr. </span>2002;<span class="ref-vol">21</span>:438–40.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/12430564" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12430564</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM1208.REF.5">Elchlal U, Sela HY, Gimmon Z. Defying physical limitations: Successful pregnancy and birth in a patient on home total parenteral nutrition since infancy. <span><span class="ref-journal">Eur J Obstet Gynecol Reprod Biol. </span>2009;<span class="ref-vol">147</span>:111–2.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/19619931" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19619931</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="LM1208.REF.6">Wessel AE, Mogensen KM, Rohr F, et al. Management of a woman with maple syrup urine disease during pregnancy, delivery, and lactation. <span><span class="ref-journal">JPEN J Parenter Enteral Nutr. </span>2015;<span class="ref-vol">39</span>:875–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24618664" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24618664</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="LM1208.REF.7">Buchholz BM, Ruland A, Kiefer N, et al. Conception, pregnancy, and lactation despite chronic intestinal failure requiring home parenteral nutrition. <span><span class="ref-journal">Nutr Clin Pract. </span>2015;<span class="ref-vol">30</span>:807–14.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/25788322" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25788322</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="LM1208.REF.8">Borbolla Foster A, Dixon S, Tyrrell-Price J, et al. Pregnancy and lactation during long-term total parenteral nutrition: A case report and literature review. <span><span class="ref-journal">Obstet Med. </span>2016;<span class="ref-vol">9</span>:181–4.</span> [<a href="/pmc/articles/PMC5089349/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5089349</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27829882" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27829882</span></a>]</div></dd></dl></dl></div></div><div id="LM1208.Substance_Identification"><h2 id="_LM1208_Substance_Identification_">Substance Identification</h2><div id="LM1208.Substance_Name"><h3>Substance Name</h3><p>Parenteral Nutrition</p></div><div id="LM1208.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Parenteral Nutrition</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK500786_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">June 21, 2021</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Parenteral Nutrition. [Updated 2021 Jun 21].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/parathyroid_hormone/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM1241/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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