Safe Medications To Take While Breastfeeding

One of the most frequent topics people ask me about is medications and breastfeeding. As breastfeeding mothers, we are always considering how our food, drink, and medication intake might affect our growing child. Thankfully, in the vast majority of cases, you can take medication when breastfeeding or there will be a suitable alternative.¹ You will rarely have to stop breastfeeding or “pump and dump” because of a medication. As Dr. Thomas W. Hale states, most drugs are safe to take for breastfeeding mothers.² Let’s explore why and take a look at some specific medications that can be safe to use while breastfeeding.

Why Is It Okay To Keep Breastfeeding?

So often, healthcare professionals tell women that they have to temporarily stop breastfeeding their child because of a medication prescribed. Virtually every medication in existence will say, “Do not take if pregnant or breastfeeding,” which is a standard general recommendation on all packaging. However, it’s important to look at the research and understand how a medication is transferred by the mother and absorbed by the baby.

According to the Mayo Clinic, at least some amount of medication will transfer from a mother’s blood into her breast milk. But for the most part, it would only be a low level (depending on the specific type).¹ One study in 2011 found that “most newer antidepressants produce very low or undetectable plasma concentrations in nursing infants.”³ And a report from the American Academy of Pediatrics (AAP) explains that “only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants,” though there are exceptions.⁴ You can see why most medications are okay to take while breastfeeding — as long as your healthcare provider agrees!^1,4

When Should I Stop Breastfeeding Due to Medication?

On rare occasions (for example, a woman taking chemotherapy drugs), a woman would have to discontinue breastfeeding.^5,6 The AAP report (mentioned above) notes that, even though most medications won’t harm the breastfeeding mother or baby, you must consider the “individual risk/benefit ratio,” so make sure to get your doctor’s input on any medication you plan to take while breastfeeding.⁴ Some factors to consider about the medication itself and your breastfeeding child include:^7,8,9

• The relative infant dose (how much the baby will receive exposure to)
• Whether your baby is full-term, premature, or unwell
• How old your baby is
• How much milk they’re getting within a 24-hour period
• The medication’s properties (half-life, protein binding, oral bioavailability, and molecular weight)

Common Medications and Breastfeeding

Here are some types of medications you may take while breastfeeding, along with how they might impact you and your baby:¹

1. Decongestants

In some cases, a decongestant or antihistamine temporarily decreases your supply.^10,11,12 This is due to the nature of this type of medication, which constricts the blood vessels and reduces blood flow to the breasts.^11,13,14,15 However, not everyone will notice a decrease because of this. If your milk supply is well-established and your feeding is going well, you may have no reaction. If you do notice a bit of a decrease, stop taking the medication.

2. Antibiotics

You can continue to breastfeed when taking antibiotics.¹⁶ However, you might notice that your baby has some digestive upset (loose stool, for example) from the medication.¹⁷ Taking probiotics during the course of taking your medication and for a few months after you’ve finished is important.¹⁶ The good bacteria from the probiotics will go through your milk.¹⁸ It can help your baby, too, if they have some digestive side effects. It’s also very beneficial to eat and drink fermented and cultured foods filled with good bacteria, so try to incorporate these into your diet every day.^17,19

3. Pain Medication

Over-the-counter pain meds are usually compatible with breastfeeding.²⁰ However, if you’re taking opioid pain medications, it’s important to seek advice, as it will depend on the amount you take (the dose), the length of time you’ll be taking it, and how old your baby is. The use of opioids following a cesarean section is generally safe.²⁰ This will be short-term, and baby will get a smaller dose with a very small volume of milk since it’s mostly colostrum.²¹ However, if you will be taking opioids for the longer term and breastfeeding a premature or sick baby, it might not be compatible with breastfeeding. There will likely be an alternative that’s a better option for you and your baby.

The Bottom Line

Remember, in most cases, the benefits of continuing to breastfeed outweigh any possible side effects from a medication.¹ If your doctor or pharmacist has told you not to breastfeed when taking a medication, it’s also important to seek advice from an International Board Certified Lactation Consultant (IBCLC). Also, refer to respected resources such as “Hale’s Medications & Mothers’ Milk,” which will help you make an informed decision. It isn’t uncommon for women to be told they can’t breastfeed when, in most cases, they can!

Note: This article is for general information purposes only. Always seek the advice of your doctor, lactation consultant, or IBCLC when taking medication while breastfeeding.