Medicine While Breastfeeding

It is possible to take medicine while breastfeeding if necessary. There are very few kinds of medicine treatments that absolutely contradict breastfeeding, although, there are some medications when taken by a breast feeding mother that may cause side effects in the baby.

It is safe to take pain relievers such as Tylenol or Advil when you have a headache or a fever.

Sometimes there is a need to decide whether a mother who is breastfeeding and who needs drug treatment can take the necessary medication and still continue breastfeeding safely.

Some mothers choose to use safe herbal substances. When mothers have a need they may take galactagogues to increase milk production.

Safely using medications requires a basic knowledge of how drugs enter breast milk, which drugs present risks, and what factors may or may not affect the baby's sensitivity to the medicine being used.

Although there are many exceptions, a basic rule of thumb is that 1% of the dose that you take will find its way into your breast milk and therefore be given to your baby. Relative baby does of less than 10% are generally considered safe for babies.

Always consult a medical practitioner who is knowledgeable about pharmacology and compatibility with breastfeeding before taking any medicine while breastfeeding.

Read Dr. Thomas Hale's article about medicine while breastfeeding and how drugs enter milk.

There are five ways of classifying compatibility of medicine while breastfeeding

1. Compatible with breastfeeding - usually safe

Medicine is classified as compatible with breastfeeding if there are no known or theoretical contraindications for its use, and it is considered safe for the mother to take the medication and continue breastfeeding.

2. Compatible with breastfeeding - usually safe - monitor baby for side effects

Medicine is classified in this way if it could theoretically cause side-effects in the infant but has either not been observed to do so or has only rarely caused mild side effects.

If side effects occur while taking this type of medication, your doctor should stop giving you the medication, and if needed, find an alternative.

If you must continue taking the medication, you may be advised to stop breastfeeding and feed your baby artificially until treatment is completed. In this case, you may decide to express your breastmilk to keep up the supply so that you can breastfeed again when you complete your treatment.

3. Avoid if possible - monitor baby for side effects

Mothers are advised to avoid medicine that has been reported to cause side effects in babies. Medications under this classification are only prescribed when they are essential for the mother’s treatment and when no safer alternative is available.

If you must take such a medication, you may be allowed to continue breastfeeding but given clear instructions about observing the baby and arrange for frequent check-ups.

If side effects occur, you may be advised to stop taking the medicine. If it is not possible to stop treatment, you may have to stop breastfeeding and feed the baby artificially until treatment is completed. In this case, you may decide to express your breastmilk to keep up the supply so that you can breastfeed again when you complete your treatment.

4. Avoid if possible - may inhibit lactation.

5. Incompatible With Breastfeeding

Anticancer drugs (antimetabolites)

Radioactive substances (stop breastfeeding temporarily - pump-and-dump)

Antineoplastic and immunosuppressive medication

General Information About Medicine and Breastfeeding

Anaesthetics

If a procedure requires anaesthesia, you may choose to express your breastmilk in advance and store it so that your baby can be fed expressed breastmilk while you are is undergoing and recovering from the anaesthesia medicine.

Analgesics and Antipyretics and nonsteroidal anti-inflammatory drugs (NSAIDS)

Ibuprofen and paracetamol medicines have the best documentation on safety during breastfeeding.

Cold Medicine
Information about using cold medicine while breastfeeding.

Diuretics

Large doses of short-acting diuretic medicine and usual doses of loop diuretics or long-acting diuretics can inhibit lactation and should be avoided while breastfeeding, if possible.

Topical Dermatological Medicine

Topical ointments, lotions, and preparations are not usually absorbed in significant amounts and can usually be used safely while breastfeeding.

Galactagogues

Herbal and prescribed medications to increase milk production.