Which Medications Are Safe While Breastfeeding?
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If you're a nursing parent considering taking medication, you probably have lots of questions. You may be wondering if an over-the-counter or prescription medicine could negatively affect your baby, for example, or whether it could disrupt breastfeeding in some way. These are common and understandable concerns.
Thankfully, as the Academy of American Pediatrics (AAP) notes, most medications are compatible with breastfeeding. That said, because there isn't a lot of data on some medications, and because the long-term effects of many medications are unknown, the AAP advises "to take medication only when absolutely necessary, and to take the lowest dose for the shortest time possible."
Here's what breastfeeding parents need to know about taking cold and flu medicines, allergy medicines, pain relievers, prescription medicines, herbal remedies, and more.
Can You Take Medication While Breastfeeding?
When it comes to breastfeeding, "the good news is most medications are fairly 'safe,' meaning there haven't been bad side effects seen in babies," says Jenelle Ferry, M.D., neonatologist and director of feeding, nutrition and infant development at Pediatrix Neonatology of Florida. Usually, if you got the go-ahead to take a medication while pregnant, you can continue using it while nursing.
The problem, says Dr. Ferry, is that experts have a decent understanding of how some medications affect babies—but there's very little information about others. For this reason, it's always best to check with your pediatrician or lactation consultant before taking any particular medication.
Hali Shields, a certified IBCLC and lactation education counselor, and the senior doula at New Kind, explains that all mediations pass into breast milk, but usually the amount that a baby consumes is quite low. It's rarely recommended that a breastfeeding parent give up breastfeeding to take medication, she says. Still, there are certain medications that are almost always off-limits when you are breastfeeding. "Cancer drugs, some beta-blockers, opioids, epilepsy and seizure drugs, radioactive drugs, and all illicit drugs would not be compatible with lactation," says Shields.
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In addition to speaking with your pediatrician or lactation consultant, Shields recommends that you bookmark the LactMed database, a free resource maintained by the National Library of Medicine that allows you to look up any given medication. You'll be able to find information and studies about its compatibility with breastfeeding.
Here's what to know about some of the most common medications you may take while nursing.
Cold and Flu Medications
Most over-the-counter decongestants, cough syrups, and cold and flu medications are considered safe during breastfeeding, including Delsym (dextromethorphan) and Mucinex (guaifenesin). However, it's important to note that certain ingredients in cold medicines—such as pseudoephedrine, which is found in Sudafed and Zyrtec D—are known to significantly decrease milk supply.
Allergy Medications
The majority of common allergy medications are considered safe during breastfeeding. But consider that some allergy meds make you drowsy and have the potential to make your baby drowsy as well. It's usually recommended that you stick to non-drowsy allergy medications such as Claritin (loratadine) and Clarinex (desloratadine), and shy away from sedating allergy meds like Benadryl (diphenhydramine) and Zyrtec (cetirizine).
Pain Relievers
Most of the most common pain medications, such as Advil (ibuprofen) and Tylenol (acetaminophen), are considered safe during breastfeeding, and very little of these medications are known to pass into breast milk. Aspirin should be limited, as it can be harmful to babies; medications with codeine are usually not considered safe.
Antidepressants
If you are experiencing mental health challenges, including postpartum depression, you don't have to stop breastfeeding to treat it. Zoloft (sertraline) is usually the first antidepressant that's considered, because it's known to excrete in low amounts in breast milk and side effects for babies are minimal. But there are other options, and you should discuss the best choice for you with your health care provider.
Birth Control
Oral contraceptives are not off the table when you're nursing. Although birth control containing high levels of estrogen might impact your milk supply, taking a progestin-only birth control pill is considered compatible with breastfeeding.
Herbal Remedies
According to the AAP, many herbal remedies are likely safe for breastfeeding parents. The issue is that there is very little research on them, and herbs and other natural remedies are not regulated by the Food and Drug Administration (FDA). You should always discuss an herbal remedy with your health care provider before taking it while breastfeeding.
Safety Tips for Taking Medicine While Nursing
It's important to check with your pediatrician or lactation consultant before using any given mediation. They can advise you whether it's safe to take, in what amounts, and whether any other precautions need to be followed. "Know that a dialogue with your baby's physician is important, and for most medications, the benefits of providing human milk to your infant still outweigh potential side effects from medications," says Dr. Ferry.
It's only necessary to refrain from breastfeeding, or "pump and dump," if you're using medication that's not compatible with breastfeeding, Shields explains.
In cases where you're taking safe medication, but want to minimize your baby's exposure to it, the AAP suggests choosing a short-acting medicine that's eliminated from your body quickly. The best time to take it is right after you've breastfed your baby; this way, the medication will likely clear your system before your next nursing session.
According to Shields, you should always watch your baby for side effects when you have taken a medication. These might include appetite changes, excessive crying, skin rashes, gastrointestinal symptoms, and fatigue. "Babies may react differently to various medications," Shields explains. She recommends trusting your instincts and never hesitating to contact your pediatrician if you think your baby is having a reaction.
