Drugs and Breastfeeding
While it is preferable to avoid taking medication during breastfeeding, it is rare that breastfeeding has to be stopped if a mother requires medication. Most drugs do appear in the milk, but only in very tiny amounts. A very few drugs may cause problems for infants even in small doses, but this is not the case for the vast majority of drugs, and safe alternatives are often available. Breastfeeding brings such significant health benefits to both mother and baby that every effort should be made to support breastfeeding during treatment.
Most drugs can be considered safe for the mother to take while breastfeeding if: they are commonly prescribed for infants (e.g., amoxycillin, other antibiotics); they are considered safe during pregnancy, although there may be exceptions; and they are not absorbed from the stomach or intestines, such as drugs given by injection.
The following frequently used medications are also generally safe to use during lactation:
- acetaminophen (e.g. Tylenol, Tempra)
- aspirin (usual doses, short term)
- most blood pressure medications
- codeine
- most non-steroidal anti-inflammatory medications (e.g. ibuprofen)
- thyroxine
- warfarin, coumadin
- sertraline (Zoloft)
- other antidepressants (use caution, monitor infant with Prozac)
- metronidazole (Flagyl), Macrobid
- alcohol (in small amounts)
- most anti-epileptic medications
- tetracycline, short-term
- prednisone
- propylthiouracil (PTU)
- trycyclic antidepressants
- paroxetine (Paxil)
- Nix, Kwellada (avoid lindane)
Medications applied to the skin, inhaled, or applied to the eyes or nose are almost always safe during breastfeeding. Breastfeeding is safe after general, regional or local anesthesia, and medications taken for pain following childbirth are almost always permitted. Immunizations given to the mother are also OK, including those with live viruses such as German measles and hepatitis A and B.
Breastfeeding mothers and physicians who have questions about medication safety can consult with a pharmacist or lactation consultant. An excellent website for up-to-date information on the topic of medication use during lactation is http://neonatal.ama.ttuhsc.edu/lact/ hosted by Thomas Hale, Ph.D. Try to get reliable information before stopping breastfeeding. Once you have stopped it may be difficult to restart, especially if the baby is very young.