Breastfeeding offers a range of health benefits for a mother and her newborn baby. Breastmilk offers the baby protection against infection and studies have indicated that breastfed children are less likely to develop skin allergies, asthma, diabetes and bowel disease later in life and have improved cognitive development. [1] Breastfeeding also helps bonding between a mother and her baby.
Although it is always advisable for nursing mothers to tell their doctor or pharmacist that they are breastfeeding, nursing mothers do not necessarily need to avoid taking all types of medication. Most medication is considered safe for breastfeeding mothers. However, exposure to medication in breastmilk poses a significant risk to babies.
While many medications can potentially harm a developing fetus during pregnancy, most medications do not pass through to the breastmilk in sufficient quantities to harm the health of the newborn baby. Natural barriers are contained in the cells that produce breastmilk that make it difficult for most medication to be passed into the milk. Any medication that does transfer through to the breastmilk only does so in small amounts, well below the therapeutic dose for an infant.
Taking medication while breastfeeding involves striking a balance between protecting a nursing mother from the potential harm of not treating her underlying condition, and protecting her baby from exposure to the medication. Avoiding medication altogether may actually cause harm to the mother and her baby if a medical condition goes untreated.
There are some established ways to minimize the transfer of medications to the nursing baby, including:
If a medication is prescribed that may be harmful to the baby, you will need to stop breastfeeding at least temporarily, and use a breast pump to maintain your milk supply until you can resume breastfeeding. Your doctor can advise you on when and how long to cease breastfeeding for.
While taking medications, monitor the newborn for any unusual signs or symptoms, such as a rash, sleeping changes or change in their mood.
Most medications do not pass through to the breastmilk in sufficient quantities to harm the health of a newborn baby.
A harmful, hypersensitive immune reaction to usually innocuous environmental substances.
The fundamental unit of life; the simplest living unit that can exist, grow, and reproduce independently. The human body is composed of trillions of cells of many kinds.
A metabolic disorder that is caused by problems with insulin secretion and regulation and which is characterized by high blood sugar levels. Also known as diabetes mellitus.
An unborn human, from the ninth week of pregnancy until birth.
Entry into the body of microorganisms that can reproduce and cause disease.
Relating to cognition, which are the mental processes and abilities associated with acts of judgement, reasoning and understanding.
Chronic diseases that affect the digestive system, such as ulcerative colitis and Crohn's disease.
Breastfeeding support and promotion. The Royal Children’s Hospital Melbourne. Accessed 19 November 19 2014, from
The non-sedating antihistamines loratadine and fexofenadine are considered safe. However, some older antihistamines may cause irritability or sleepiness in the newborn baby. Such preparations include promethazine and pheniramine.
Nasal sprays with beclomethasone, fluticasone or budesonide are considered safe, as are eye drops containing antazoline and naphazoline.
Since the evidence is still unclear on the safety of anesthetic agents with breastfeeding, is it usually advised to stop breastfeeding for 24 hours, and to dispose of breastmilk during this time ('pump and dump'). Usually, breastfeeding can resume thereafter. However, it is best to discuss your breastfeeding plan with your anesthetist before your procedure.
Penicillins, cephalosporins and macrolides are considered safe antibiotics to take while breastfeeding. Quinolones have not been well studied and are not recommended.
Warfarin does not appear to pass into breastmilk and is considered safe.
Cabamazepine, ethosuximide, magnesium sulfate and phenytoin are considered safe; however, there may be some risks associated with the use of valproic acid.
Loperamide is considered safe.
Fluconazole, miconazole and ketoconazole are considered safe.
Beta-blockers and diuretics that are commonly used as antihypertensives are generally considered safe at standard doses. The beta-blockers propranolol, metoprolol and labetalol are considered safe; however, atenolol, nadolol and sotalol may not be recommended.
The evidence is still unclear about the safety of long-term use of these drugs in nursing mothers. They may alter the function of the nervous system.
For treatment of depression, evidence indicates that selective serotonin reuptake inhibitors (SSRIs) may be a better choice, although this may require ongoing monitoring of the breastmilk and baby.
Acyclovir and valaciclovir are considered safe.
Inhaled asthma medication is considered safe for breastfeeding mothers. Oral steroids such as prednisone or prednisolone only pass minimally into the breastmilk and are considered safe. For daily dosages over 20mg, prednisolone may be preferred over prednisone.
Nasal spray decongestants and saline nasal drops are considered safe, but oral preparations that contain pseudoephedrine may reduce milk production and cause irritability in the baby.
Most cough medicines are safe, but preparations containing pseudoephedrine and phenylephrine may cause irritability in the baby and reduce milk production.
Most lozenges for sore throats are also safe to use, but those containing povidone-iodine are not recommended.
The safest laxatives are those using fiber-based products. Taking large doses of preparations containing senna may cause diarrhea in the baby.
The progesterone-only pill is considered the best option for contraception during breastfeeding, as it has only minimal transfer to the breastmilk and does not affect milk production, whereas the combined estrogen-progesterone pill may decrease the quantity and alter the composition of the milk.
Injectable contraceptives are only excreted into the breastmilk at very low amounts and are considered safe to use. The morning-after pill is considered safe for emergency contraception.
B-group vitamins are considered safe. However, herbal preparations may contain chemical substances that could be harmful to the baby and are not recommended.
Using higher than the standard dose of any dietary supplement is not recommended.
Famotidine, omeprazole and cimetidine are considered safe.
In general, it is considered safe for a nursing mother to receive most vaccinations.
Because insulin is not excreted into breastmilk, it is considered safe.
Pain can be treated during lactation with a range of medication. Poorly-managed pain can potentially lead to depression and anxiety.
Acetaminophen is considered safe, as the baby only receives around 6% of the maternal dose. Ibuprofen, diclofenac, indomethacin and naproxen are also considered safe, as the baby only receives around 1% of the maternal dose.
Aspirin is not considered safe as it may be associated with adverse effects; the infant dose is around 10% of the maternal dose. There is also a potential link with Reye's syndrome.
Short-term use of opioids is not likely to be a risk to the infant, but longer-term or chronic use may be potentially dangerous. If longer-term pain relief is required during breastfeeding, other options may be considered.
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
Substances that hinder the activity of hormones such as adrenaline by blocking the beta receptors, found in many organs but particularly the heart and blood vessels. These are used to treat a range of conditions including high blood pressure and migraines.
A mental health disorder that results in physical and psychological symptoms such as low mood, a feeling of hopelessness, poor concentration and motivation, disruptive sleep patterns and appetite changes. To be diagnosed with depression, these symptoms must be present most days for at least two weeks.
A hormone secreted by the pancreas in order to regulate glucose levels in the body's cells, which is used for energy.
A chemical element important for hormone development that is found in foods including dairy products, seafood, eggs, bread and some vegetables. It is often used in medicine as a dye.
The extensive network of cells and structures that is responsible for activating and coordinating the body's functions, sensory input and cognition.
One of a group of steroid hormones involved in the development and maintenance of female sex characteristics. These are the primary female sex hormones.
A type of antidepressant medication.
The practice of administering a vaccine, a solution containing a microorganism (that causes a specific disease) in a dead or weakened state, or parts of it, for the purpose of inducing immunity in a person to that microorganism.
A life-threatening condition that can occur in young children, characterized by brain inflammation and liver failure. Aspirin is a potential cause, especially when used in young children and teenagers with chickenpox, flu-like symptoms or other viral infections.
Medications that are not considered safe for your baby while you are breastfeeding include:
A chemical element important for hormone development that is found in foods including dairy products, seafood, eggs, bread and some vegetables. It is often used in medicine as a dye.
A metal element that is used in medications that treat psychiatric illnesses.
A group of medications that act like vitamin A, a fat-soluble vitamin essential for bone growth, vision and reproduction.