European Journal of Clinical Pharmacology

, Volume 70, Issue 11, pp 1313–1324 | Cite as

Breastfeeding and migraine drugs

  • Riccardo Davanzo
  • Jenny Bua
  • Giulia Paloni
  • Giulia FacchinaEmail author
Review Article



Breastfeeding women may suffer from migraine. While we have many drugs for its treatment and prophylaxis, the majority are poorly studied in breastfeeding women. We conducted a review of the most common anti-migraine drugs (AMDs) and we determined their lactation risk.


For each AMD, we collected all retrievable data from Hale’s Medications and Mother Milk (2012), from the LactMed database (2014) of the National Library of Medicine, and from a MedLine Search of relevant studies published in the last 10 years.


According to our review, AMDs safe during breastfeeding are as follows: low-dose acetylsalicylic acid (ASA), ibuprofen, sumatriptan, metoprolol, propranolol, verapamil, amitriptyline, escitalopram, paroxetine, sertraline, acetaminophen, caffeine, and metoclopramide. AMDs compatible with breastfeeding but warranting caution are as follows: diclofenac, ketoprofen, naproxen, most new triptans, topiramate, valproate, venlafaxine, and cyproheptadine. Finally, high-dose ASA, atenolol, nadolol, cinnarizine, flunarizine, ergotamine, methysergide, and pizotifen are contraindicated.


According to our review, the majority of the revised AMDs were assessed to be compatible with breastfeeding.


Migraine drugs Breastfeeding Lactation risk Human milk 



We thank Prof Thomas Hale, Texas Tech University, School of Medicine, Amarillo, Texas, for helpful advice.

Conflict of interest

This study was performed without any funding or grants. All authors declare that they have no competing interest and do not have any financial relationships with any biotechnology and/or pharmaceutical manufacturers.


  1. 1.
    Manzoni GC, Stovner LJ (2010). Epidemiology of headache. Handbook of clinical neurology 97:3–22Google Scholar
  2. 2.
    Smitherman TA, Burch R, Sheikh H et al (2013) The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache 53(3):427–436PubMedGoogle Scholar
  3. 3.
    Kvisvik EV, Stovner LJ, Helde G et al (2011) Headache and migraine during pregnancy and puerperium: the MIGRA-study. J Headache Pains 12(4):443–451Google Scholar
  4. 4.
    Hoshiyama E, Tatsumoto M, Iwanami H et al (2012) Postpartum migraines: a long-term prospective study. Intern Med 51(22):3119–3123PubMedGoogle Scholar
  5. 5.
    Hutchinson S, Marmuta MJ, Calhoun A et al (2013) Use of common migraine treatments in breastfeeding women: a summary of recommendations. Headache 53(4):614–627PubMedPubMedCentralGoogle Scholar
  6. 6.
    Antonaci F, Dumitrache C, De Cillis I et al (2010) A review of current European treatment guidelines for migraine. J Headache Pain 11:13–19PubMedPubMedCentralGoogle Scholar
  7. 7.
    Silberstein SD, Holland S, Freitag F et al (2012) Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 78(17):1337–1345PubMedPubMedCentralGoogle Scholar
  8. 8.
    Holland S, Silberstein SD, Freitag F et al (2012) Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 78(17):1346–1353PubMedPubMedCentralGoogle Scholar
  9. 9.
    Atkinson HC, Begg EJ, Darlow BA (1988) Drugs in human milk. Clinical pharmacokinetic considerations. Clin Pharmacokinets 14:217–240Google Scholar
  10. 10.
    Bennett PN (1996) Drugs and human lactation. Elsevier, AmsterdamGoogle Scholar
  11. 11.
    Hale TW (2012) Medication and mothers’ milk. Hale Publishing, AmarilloGoogle Scholar
  12. 12.
  13. 13.
    Voelker M, Hammer M (2012) Dissolution and pharmacokinetics of a novel micronized aspirin formulation. Inflammopharmacology 20(4):225–231PubMedPubMedCentralGoogle Scholar
  14. 14.
    Unsworth J, D’Assis Fonseca A, Beswick DT (1987) Serum salicylate levels in a breast fed infants. Annals Rheum Diseases 46:638–639Google Scholar
  15. 15.
    Bailey DN, Weibert RT, Naylor AJ et al (1982) A study of salicylate and caffeine excretion in the breast milk of two nursing mothers. J Anal Toxicol 6:64–68PubMedGoogle Scholar
  16. 16.
    Terragna A, Spirito L (1967) Thrombocytopenic purpura in an infant after administration of acetylsalicylic acid to the wet-nurse. Minerva Pediatr 19(13):613–616PubMedGoogle Scholar
  17. 17.
    Clark JH, Wilson WG (1981) A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate. Clin Pediatr (Phila) 20(1):53–54Google Scholar
  18. 18.
    Bell AD, Roussin A, Cartier R et al (2011) The use of antiplatelet therapy in the outpatient setting: Canadian Cardiovascular Society Guidelines Executive Summary. Can J Cardiol 27(2):208–221PubMedGoogle Scholar
  19. 19.
    Spigset O, Hagg S (2000) Analgesics and breast-feeding: safety considerations. Paediatr drugs 2(3):223–238PubMedGoogle Scholar
  20. 20.
    Hirose M, Hara Y, Hosokawa T et al (1996) The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. Anesth Analg 82:1166–1169PubMedGoogle Scholar
  21. 21.
    Needs CJ, Brooks PM (1985) Antiirheumatic medication during lactation. Br J Rheumatol 24(3):291–297PubMedGoogle Scholar
  22. 22.
    Townsend RJ, Benedetti TJ, Erickson SH et al (1984) Excretion of ibuprofen into breast milk. Am J Obstet Gynecol 149:184–186PubMedGoogle Scholar
  23. 23.
    Perrott DA, Piira T, Goodenough B et al (2004) Efficacy and safety of acetaminophen vs ibuprofen for treating children’s pain or fever: a meta-analysis. Arch Pediatr Adolesc Med 158(6):521–526PubMedGoogle Scholar
  24. 24.
    Aranda JV, Thomas R (2006) Systematic review: intravenous ibuprofen in preterm newborns. Semin Perinatol 30:114–120PubMedGoogle Scholar
  25. 25.
    Ohlsson A, Walia R, Shah SS (2010). Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants. Cochrane Database Syst Rev. CD003481Google Scholar
  26. 26.
    Davanzo R (2005) Farmaci ed allattamento al seno. In: Farmaci e gravidanza. La valutazione del rischio basata su prove di efficacia. Agenzia Italiana del Farmaco (AIFA) Ministero della Salute Istituto Poligrafico e Zecca dello Stato S.p.A. RomaGoogle Scholar
  27. 27.
    Jacqz-Aigrain E, Serreau R, Boissinot C et al (2007) Excretion of ketoprofen and nalbuphine in human milk during treatment of maternal pain after delivery. Ther Drug Monit 29(6):815–818PubMedGoogle Scholar
  28. 28.
    Risser A, Donovan D, Heintzman J et al (2009) NSAID prescribing precautions. Am Fam Physician 80:1371–1378PubMedGoogle Scholar
  29. 29.
    Jamali F, Stevens DR (1983) Naproxen excretion in milk and its uptake by the infant. Drug Intell Clin Pharm 17:910–911PubMedGoogle Scholar
  30. 30.
    Fidalgo I, Correa R, Gomez Carrasco JA et al (1989) Acute anemia, rectorrhagia and hematuria caused by ingestion of naproxen. An Esp Pediatr 30:317–319PubMedGoogle Scholar
  31. 31.
    Ito S, Blajchman A, Stephenson M et al (1993) Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol 168:1393–1399PubMedGoogle Scholar
  32. 32.
    Goadsby PJ, Goldberg J, Silberstein SD (2008) Migraine in pregnancy. Br Med J 336:1502–1504Google Scholar
  33. 33.
    Silberstein SD, Goadsby PJ (2002) Migraine: preventive treatment. Cephalalgia 22(7):491–512PubMedGoogle Scholar
  34. 34.
    Duong S, Bozzo P, Nordeng H et al (2010) Safety of triptans for migraine headaches during pregnancy and breastfeeding. Can Fam Physician 56:537–539PubMedPubMedCentralGoogle Scholar
  35. 35.
    Eiland LS, Hunt MO (2010) The use of triptans for pediatric migraines. Paediatr Drugs 12:379–389PubMedGoogle Scholar
  36. 36.
    O’Brien HL, Kabbouche MA, Hershey AD (2010) Treatment of acute migraine in the pediatric population. Curr Treat Options Neurol 12(3):178–185PubMedGoogle Scholar
  37. 37.
    Wojnar-Horton RE, Hackett LP, Yapp P et al (1996) Distribution and excretion of sumatriptan in human milk. Br J Clin Pharmacol 41:217–221PubMedGoogle Scholar
  38. 38.
    American Academy of Pediatrics Committee on Drugs (2001) The transfer of drugs and other chemicals into human milk. Pediatrics 108(3):776–789Google Scholar
  39. 39.
    Jurgens TP, Schaefer C, May A (2009) Treatment of cluster headache in pregnancy and lactation. Cephalalgia 29(4):391–400PubMedGoogle Scholar
  40. 40.
    Thorley KJ, McAinsh J (1983) Levels of the beta-blockers atenolol and propranolol in the breast milk of women treated for hypertension in pregnancy. Biopharm Drug Dispos 4(3):299–301PubMedGoogle Scholar
  41. 41.
    Liedholm H, Melander A, Bitzen PO et al (1981) Accumulation of atenolol and metoprolol in human breast milk. Eur J Clin Pharmacol 20:229–231PubMedGoogle Scholar
  42. 42.
    White WB, Andreoli JW, Wong SH et al (1984) Atenolol in human plasma and breast milk. Obstet Gynecol 63(3 Suppl):42S–44SPubMedGoogle Scholar
  43. 43.
    Eyal S, Kim JD, Anderson GD et al (2010) Atenolol pharmacokinetics and excretion in breast milk during the first 6 to 8 months postpartum. J Clin Pharmacol 50:1301–1309PubMedPubMedCentralGoogle Scholar
  44. 44.
    Schimmel MS, Eidelman AI, Wilschanski MA et al (1989) Toxic effects of atenolol consumed during breast feeding. J Pediatr 114:476–478PubMedGoogle Scholar
  45. 45.
    Sandstrom B, Regardh CG (1980) Metoprolol excretion into breast milk. Br J Clin Pharmacol 9(5):518–519PubMedPubMedCentralGoogle Scholar
  46. 46.
    Kulas J, Lunell NO, Rosing U et al (1984) Atenolol and metoprolol. A comparison of their excretion into human breast milk. Acta Obstet Gynecol Scand Suppl 118:65–69PubMedGoogle Scholar
  47. 47.
    Devlin RG, Duchin KL, Fleiss PM (1981) Nadolol in human serum and breast milk. Br J Clin Pharmacol 12:393–396PubMedPubMedCentralGoogle Scholar
  48. 48.
    Davanzo R, Rubert L, Oretti C (2008) Meta-variability of advice on drugs in the breastfeeding mother: the example of beta-blockers. Arch Dis Child Fetal Neonatal Ed 93:249–250Google Scholar
  49. 49.
    Anderson PO (1979) Propranolol in breast milk. Am J Psychiatry 136:466PubMedGoogle Scholar
  50. 50.
    Tosoni C, Lodi-Rizzini F, Bettoni L et al (2003) Cinnarizine is a useful and well-tolerated drug in the treatment of acquired cold urticaria (ACU). Eur J Dermatol 13:54–56PubMedGoogle Scholar
  51. 51.
    Turner D, Lurie Y, Finkelstein Y et al (2006) Pediatric cinnarizine overdose and toxicokinetics. Pediatrics 117:1067–1069Google Scholar
  52. 52.
    Andersen HJ (1983) Excretion of verapamil in human milk. Eur J Clin Pharmacol 25:279–280PubMedGoogle Scholar
  53. 53.
    Anderson P, Bondesson U, Mattiasson I et al (1987) Verapamil and norverapamil in plasma and breast milk during breast feeding. Eur J Clin Pharmacol 31:625–627PubMedGoogle Scholar
  54. 54.
    Gluskin LE, Strasberg B, Shah JH (1981) Verapamil-induced hyperprolactinemia and galactorrhea. Ann Intern Med 95:66–67PubMedGoogle Scholar
  55. 55.
    Fearrington EL, Rand CH, Rose JD (1983) Hyperprolactinemia-galactorrhea induced by verapamil. Am J Cardiol 51:1466–1467PubMedGoogle Scholar
  56. 56.
    Davanzo R, Dal Bo S, Bua J et al (2013) Antiepileptic drugs and breastfeeding. Ital J Pediatr 39:50PubMedPubMedCentralGoogle Scholar
  57. 57.
    Ohman I, Vitols S, Luef G et al (2002) Topiramate kinetics during delivery, lactation, and in the neonate: preliminary observations. Epilepsia 43(10):1157–1160PubMedGoogle Scholar
  58. 58.
    Gentile S (2009) Topiramate in pregnancy and breastfeeding. Clin Drug Investig 29(2):139–141PubMedGoogle Scholar
  59. 59.
    Wyllie E, Wyllie R (1991) Routine laboratory monitoring for serious adverse effects of antiepileptic medications: the controversy. Epilepsia 32(Suppl 5):S74–S79PubMedGoogle Scholar
  60. 60.
    Chaudron LH, Jefferson JW (2000) Mood stabilizers during breastfeeding: a review. J Clin Psychiatry 61(2):79–90PubMedGoogle Scholar
  61. 61.
    Meador KJ, Baker GA, Browning N et al (2010) NEAD Study Group. Effects of breastfeeding in children of women taking antiepileptic drugs. Neurology 75(22):1954–1960PubMedPubMedCentralGoogle Scholar
  62. 62.
    Bar-Oz B, Nulman I, Koren G et al (2000) Anticonvulsants and breast feeding: a critical review. Paediatr Drugs 2:113–126PubMedGoogle Scholar
  63. 63.
    Hagg S, Spigset O (2000) Anticonvulsant use during lactation. Drug Saf 22:425–440PubMedGoogle Scholar
  64. 64.
    Wisner KL, Perel J (1998) Serum levels of valproate and carbamazepine in breastfeeding mother-infant pairs. J Clin Psychopharmacol 18(2):167–169PubMedGoogle Scholar
  65. 65.
    Orny A (2009) Valporic acid in pregnancy: how much are we endangering the embryo and fetus? Reprod Toxicol 28(1):1–10Google Scholar
  66. 66.
    Smith AK, Conneely KN, Newport DJ et al (2012) Prenatal antiepileptic exposure associates with neonatal DNA methylation differences. Epigenetics 7(5):458–463PubMedPubMedCentralGoogle Scholar
  67. 67.
    Stahl MM, Neiderud J, Vinge E (1997) Thrombocytopenic purpura and anemia in a breast-fed infant whose mother was treated with valproic acid. J Pediatr 130:1001–1003PubMedGoogle Scholar
  68. 68.
    Wallace SJ (1996) A comparative review of the adverse effects of anticonvulsants in children with epilepsy. Drug Saf 15(6):378–393PubMedGoogle Scholar
  69. 69.
    Perucca E (2002) Pharmacological and therapeutic properties of valproate: a summary after 35 years of clinical experience. CNS Drugs 16(10):695–714PubMedGoogle Scholar
  70. 70.
    Eberhard-Gran M, Eskild A, Opjordsmoen S (2006) Use of psychotropic medications in treating mood disorders during lactation: practical recommendations. CNS Drugs 20(3):187–198PubMedGoogle Scholar
  71. 71.
    Yoshida K, Smith B, Craggs M et al (1997) Investigation of pharmacokinetics and of possible adverse effects in infants exposed to tricyclic antidepressants in breast-milk. J Affect Disord 43:225–237PubMedGoogle Scholar
  72. 72.
    Wisner KL, Perel JM, Findling RL (1996) Antidepressant treatment during breast-feeding. Am J Psychiatry 153:1132–1137PubMedGoogle Scholar
  73. 73.
    Davanzo R, Copertino M, De Cunto A et al (2011) Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med 6:89–98PubMedGoogle Scholar
  74. 74.
    Nielsen RE, Damkier P (2012) Pharmacological treatment of unipolar depression during pregnancy and breast-feeding—a clinical overview. Nord J Psychiatry 66(3):159–166PubMedGoogle Scholar
  75. 75.
    Bar-Oz B, Bulkowstein M, Benyamini L et al (2003) Use of antibiotic and analgesic drugs during lactation. Drug Saf 26:925–935PubMedGoogle Scholar
  76. 76.
    Berlin CM Jr, Yaffe SJ, Ragni M (1980) Disposition of acetaminophen in milk, saliva, and plasma of lactating women. Pediatr Pharmacol (New York) 1(2):135–141Google Scholar
  77. 77.
    Notarianni LJ, Oldham HG, Bennett PN (1987) Passage of paracetamol into breast milk and its subsequent metabolism by the neonate. Br J Clin Pharmacol 24:63–67PubMedPubMedCentralGoogle Scholar
  78. 78.
    Palmer GM, Atkins M, Anderson BJ et al (2008) I.V. acetaminophen pharmacokinetics in neonates after multiple doses. Br J Anaesth 101:523–530PubMedGoogle Scholar
  79. 79.
    Allegaert K, Naulaers G (2010) Haemodynamics of intravenous paracetamol in neonates. Eur J Clin Pharmacol 66:855–858PubMedGoogle Scholar
  80. 80.
    Matheson I, Lunde PKM, Notarianni L (1985) Infant rash caused by paracetamol in breast milk? Pediatrics 76:651–652, LetterPubMedGoogle Scholar
  81. 81.
    Berlin CM, Denson HM, Daniel CH et al (1984) Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. Pediatrics 73:59–63PubMedGoogle Scholar
  82. 82.
    Stavchansky S, Combs A, Sagraves R et al (1988) Pharmacokinetics of caffeine in breast milk and plasma after single oral administration of caffeine to lactating mothers. Biopharm Drug Dispos 9:285–299PubMedGoogle Scholar
  83. 83.
    Ryu JE (1985) Effect of maternal caffeine consumption on heart rate and sleep time of breast-fed infants. Dev Pharmacol Ther 8:355–363PubMedGoogle Scholar
  84. 84.
    Tyrala EE, Dodson WE (1979) Caffeine secretion into breast milk. Arch Dis Child 54:787–800PubMedPubMedCentralGoogle Scholar
  85. 85.
    Gray PH, Flenady VJ, Charles BG et al (2011) Caffeine citrate for very preterm infants: effects on development, temperament and behaviour. J Paediatr Child Health 47:167–172PubMedGoogle Scholar
  86. 86.
    McNamara PJ, Abbassi M (2004) Neonatal exposure to drugs in breast milk. Pharm Res 21:555–566PubMedGoogle Scholar
  87. 87.
    Liston J (1998) Breastfeeding and the use of recreational drugs–alcohol, caffeine, nicotine and marijuana. Breastfeed Rev 6:27–30PubMedGoogle Scholar
  88. 88.
    Santos IS, Matijasevich A, Domingues MR (2012) Maternal caffeine consumption and infant nighttime waking: prospective cohort study. Pediatrics 129:860–868PubMedPubMedCentralGoogle Scholar
  89. 89.
    Moretti ME, Lee A, Ito S (2000) Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician 46:1753–1757PubMedPubMedCentralGoogle Scholar
  90. 90.
    Mahachoklertwattana P, Wanasuwankul S, Poomthavorn P et al (2009) Short-term cyproheptadine therapy in underweight children: effects on growth and serum insulin-like growth factor-I. J Pediatr Endocrinol Metab 22:425–432PubMedGoogle Scholar
  91. 91.
    Wortsman J, Soler NG, Hirschowitz J (1979) Cyproheptadine in the management of the galactorrhea-amenorrhea syndrome. Ann Intern Med 90:923–925PubMedGoogle Scholar
  92. 92.
    Fomina PI (1934) Untersuchungen uber den ubergang des aktiven Agens des Mutterkorns in die milch stillender Mutter. Arch Gynakol 157:275–285Google Scholar
  93. 93.
    Jolivet A, Robyn C, Huraux-Rendu C et al (1978) Effect of ergot alkaloid derivatives on milk secretion in the immediate postpartum period. J Gynecol Obstet Biol Reprod (Paris) 7(1):129–134Google Scholar
  94. 94.
    Shane JM, Naftolin F (1974) Effect of ergonovine maleate on puerperal prolactin. Am J Obstet Gynecol 120:129–131PubMedGoogle Scholar
  95. 95.
    British National Formulary (BNF) (2010). British Medical Association and Royal Pharmaceutical Society of Great Britain, LondonGoogle Scholar
  96. 96.
    Azzopardi TD, Brooks NA (2008) Oral metoclopramide as an adjunct to analgesics for the outpatient treatment of acute migraine. Ann Pharmacother 42:397–402PubMedGoogle Scholar
  97. 97.
    Friedman BW, Mulvey L, Esses D et al (2011) Metoclopramide for acute migraine: a dose-finding randomized clinical trial. Ann Emerg Med 57:475–482PubMedPubMedCentralGoogle Scholar
  98. 98.
    Ingram J, Taylor H, Churchill C (2012) Metoclopramide or domperidone for increasing maternal breast milk output: a randomized controlled trial. Arch Dis Child Fetal Neonatal Ed 97(4):F241–F245PubMedGoogle Scholar
  99. 99.
    Zuppa AA, Sindico P, Orchi C et al (2010) Safety and efficacy of galactogogues: substances that induce, maintain and increase breast milk production. J Pharm Pharm Sci 13:162–174PubMedGoogle Scholar
  100. 100.
    Ehrenkranz RA, Ackerman BA (1986) Metoclopramide effect on faltering milk production by mothers of premature infants. Pediatrics 78:614–620PubMedGoogle Scholar
  101. 101.
    Kauppila A, Arvela P, Koivisto M et al (1983) Metoclopramide and breast feeding: transfer into milk and the newborn. Eur J Clin Pharmacol 25:819–823PubMedGoogle Scholar
  102. 102.
    Barnes NP, James EK (2009). Migraine headache in children. Clin Evid (Online)Google Scholar
  103. 103.
    Silcocks P, Whitham D, Whitehouse WP (2010) P3MC: a double blind parallel group randomised placebo controlled trial of propranolol and pizotifen in preventing migraine in children. Trials 11:71PubMedPubMedCentralGoogle Scholar
  104. 104.
    Briars GL, Travis SE, Anand B et al (2008) Weight gain with pizotifen therapy. Arch Dis Child 93(7):590–593PubMedGoogle Scholar
  105. 105.
    Ip S, Chung M, Raman G, et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep). (153):1–186.Google Scholar
  106. 106.
    Schirm E, Schwagermann MP, Tobi H et al (2004) Drug use during breastfeeding. A survey from the Netherlands. Eur J Clin Nutr 58(2):386–390PubMedGoogle Scholar
  107. 107.
    Anderson A (2003) Breastfeeding: societal encouragement needed. J Hum Nutr Diet 16(4):217–218PubMedGoogle Scholar
  108. 108.
    Taketomo CK (2012–2013) Pediatric and neonatal dosage handbook. Lexi-Comp, Hudson, OHGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Riccardo Davanzo
    • 1
  • Jenny Bua
    • 1
  • Giulia Paloni
    • 2
  • Giulia Facchina
    • 2
    Email author
  1. 1.Division of Neonatology, Institute for Maternal and Child HealthIRCCS “BurloGarofolo”TriesteItaly
  2. 2.University of TriesteTriesteItaly

Personalised recommendations