TPD App Terminology & Concepts
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General Information TPD App Terminology & Concepts

TPD App Terminology & Concepts

The Trash the Pump and Dump (TPD) app is a reference guide for health conditions, medications, supplements, and exposures that necessitate caution regarding breastfeeding. Please note that there are very few medications and exposures that are absolutely contraindicated during lactation. This article reviews terminology used and general information about the TPD app.

What distinguishes TPD from other resources on medications during lactation?

The TPD app is designed to help physicians, healthcare team members, and families determine safe options within classes of medications and other exposures, such as vaccines and anesthesia. For example, TPD is designed to help a physician choose a ‘best’ option for an anti-hypertensive medication for a lactating individual. Other resources provide excellent evidence-based information on individual medications and substances, and the TPD relies on these references for their information.

Terminology

Why do we use the phrase “There is no absolute indication to pump and dump”?

We use this phrase to indicate that there is generally no need to pump and dump or disrupt lactation for a particular medication, medication class, or other exposure. We add the term “absolute” to indicate the importance of shared decision-making and individualized care. While it is not necessary to pump and dump for most medications and other exposures, there may be times when a medication or substance, typically considered safe, is not advisable for the dyad. This may arise when the child or lactating parent has a medication allergy or underlying health condition that would preclude exposure, such as the use of sulfa antibiotic in the lactating parent who is breastfeeding a jaundiced neonate. TPD has included available data on known risks of medications and exposures for infants and milk production as well as links for more in-depth resources.

Why do we use the phrase “Alternative medications should be considered (or are preferred)”?

When the phrase “alternative medications should be considered” is used, we are indicating that an alternative medication may have more data or its pharmacologic properties make it a less risky choice for lactating individuals or their infants. We recommend shared decision making, which includes the consideration of alternative options for management. It is recommended to monitor dyads for side effects or adverse events if a medication with this phrasing is taken by a lactating individual.

What medications do I need to pump and dump for?

The TPD app encompasses medications and other exposures of concern during lactation. If you are uncertain about a situation, please advise PUMPING AND SAVING! Most often dumping milk is NOT necessary, and the expressed milk can be given to the child later.

The TPD app indicates when it is recommended to pump and dump (or save) milk for certain medications and other exposures. In some situations, the milk can be saved for later, when the child is older and there is resolution of the child’s health condition. Pumping while taking a relatively contraindicated medication allows the lactating parent to maintain milk production so that breastfeeding and/or human milk feeding can resume after finishing the medication.

Where can I find more information on certain medications or other exposures, beyond what is available in the TPD app?

TPD is continuously expanded and updated regularly. More topics and articles are anticipated in the coming months. Please contact us to recommend future topics. For detailed information and references on specific medications or exposures that may or may not be in the TPD, please visit LactMed, e-lactancia, Infant Risk, or Mother to Baby.

Who are the authors?

The authors of the TPD articles are physicians and pharmacologists who are breastfeeding and lactation medicine specialists. Our authors have volunteered their time and expertise towards the creation of this resource. Where possible, sub-specialists (such as anesthesiologists or psychiatrists) with a special interest in lactation help author or review our articles.

You can learn more about our authors and editors here.

If you are interested in becoming an author, please contact IABLE through this link.

Who funds and maintains TPD?

TPD is a free web app available publicly for everyone to download and utilize. The TPD app was founded by The Institute for the Advancement of Breastfeeding and Lactation Education (IABLE). IABLE provides ongoing funding and maintenance of the TPD app. Both the TPD app and IABLE are compliant with the International Code of Marketing of Breast-Milk Substitutes. IABLE declares no conflicts of interest, such as funding with any pharmaceutical companies or industry sponsors.