ABSTRACT
BACKGROUND: Patients are receiving anticoagulants during postpartum. Literature data still is controversy in milk excretion of acenocoumarin; there are conducts in favor and against. Because of the benefits of maternal milk it's necessary to probe if acenocoumarin is excreted by human milk. OBJECTIVE: To determine the milk excretion of acenocoumarin in different periods of the postpartum and the milk excretion index in anticoagulant women. MATERIAL AND METHODS: It's an observational, descriptive and prospective study. The milk and plasma concentrations of acenocoumarin were determined in breast-feeding mothers with anticoagulation during the postpartum. ANOVA was used to determine the differences in pharmacokinetic constants in the different days of study. RESULTS: Two patients required light anticoagulation, nine moderate and five intense. The 37.5% of the new born were full term hypotrophy and the 18.75% were preterm. The highest plasma average concentration of acenocoumarin was found in day 45th postpartum (0.21 microg/mL). Acenocoumarin present in milk was found until day 30th; the average concentrations were low 0.011 microg/mL. The value of the maternal milk excretion index was 0.057 in day 45, what represents that approximately the 5% of acenocoumarin is eliminated by milk. The calculated dose of acenocoumarin that a new born could receive through maternal milk was lower than the recommended doses (1.79 microg/kg/day). CONCLUSION: These results allowed us to recommend breastfeeding in patients who are been anticoagulated with acenocoumarin.
