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For an excellent source on English composition, check out this classic book by William Strunk, Jr. on the Elements of Style. Contents include: Elementary Rules of Usage, Elementary Principles of Composition, Words & Expressions Commonly Misused, An Approach to Style with a List of Reminders: Place yourself in the background, Revise and rewrite, Avoid fancy words, Be clear, Do not inject opinion, Do not take shortcuts at the cost of clarity, … and much more. Details of The Elements of Style by William Strunk, Jr. partially available online at . Note: William Strunk, Jr. (1869–1946). The Elements of Style was first published in 1918.

Physicians must weigh the risks of replacing breastfeeding with artificial feeding against the risk of medication exposure through breast milk. Even a temporary interruption in breastfeeding carries the risk of premature weaning, with the subsequent risks of long-term artificial feeding. There are very few substances for which breastfeeding should be stopped. Generally, it is recommended that breastfeeding should be interrupted if the mother ingests most drugs of abuse, antimetabolite medications such as chemotherapeutic agents, and certain radioactive compounds. 28 Among antidepressants, cardiovascular medications, immunosuppressants, and many other classes of medications, certain drugs are preferred over others for lactating women. 7, 29 In a particular class of medications, it is best to choose a drug that has the least passage into breast milk, a shorter half-life, fewer active metabolites, and/or is used locally rather than systemically. 7, 29, 30 Physicians should counsel patients before ordering medications or procedures. Often, patients will be counseled inappropriately by well-meaning health care professionals to “pump and dump” or to stop breastfeeding based on old information or package inserts. Family physicians should be aware of up-to-date information and advocate for patients to continue breastfeeding safely. Some medications and substances, such as bromocriptine, cabergoline, pseudoephedrine 31 , and estrogen-containing oral contraceptives, are known to decrease milk supply. Contraceptive alternatives for breastfeeding mothers are discussed below (see Contraception in the Breastfeeding Mother section).

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