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What medicine can you take while breastfeeding. Safe Medications While Breastfeeding: A Comprehensive Guide for Nursing Mothers

What medications are safe to take while breastfeeding. How do medications affect breast milk. When should you stop breastfeeding due to medication. Which pain relievers are safe for nursing mothers. Are antibiotics compatible with breastfeeding. Can you take antihistamines while nursing. Is it safe to use birth control pills while breastfeeding.

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Understanding Medication Transfer to Breast Milk

Breastfeeding mothers often face the dilemma of needing to take medication while nursing their infants. Understanding how drugs interact with breast milk is crucial for ensuring the safety of both mother and child. Do all medications pass into breast milk? The short answer is yes, but the extent varies significantly.

Most medications transfer into breast milk at low levels, posing minimal risk to infants. However, some drugs can become concentrated in breast milk, necessitating careful consideration before use. Each medication must be evaluated individually to determine its safety profile for nursing mothers.

Factors Affecting Medication Transfer

  • Drug properties (molecular weight, protein binding, lipid solubility)
  • Maternal dosage and frequency of use
  • Timing of medication intake relative to breastfeeding
  • Infant’s age and health status
  • Volume of breast milk produced

Is the risk of medication exposure the same for all infants? No, certain groups are more vulnerable to potential adverse effects. Premature babies, newborns, and infants with medical conditions or impaired kidney function are at higher risk. Conversely, healthy babies over 6 months old generally have more efficient systems for processing medications that may be present in breast milk.

Safe Medications for Breastfeeding Mothers

Many medications are compatible with breastfeeding, allowing nursing mothers to manage their health without compromising their ability to breastfeed. Here’s a list of commonly used medications considered safe during lactation:

Pain Relievers and Anti-inflammatory Drugs

  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Naprosyn) – for short-term use only

Antimicrobial Medications

  • Fluconazole (Diflucan)
  • Miconazole (Monistat 3) – apply minimally
  • Clotrimazole (Mycelex, Lotrimin) – apply minimally
  • Penicillins (e.g., amoxicillin, ampicillin)
  • Cephalosporins (e.g., cephalexin)

Antihistamines

  • Loratadine (Claritin, Alavert)
  • Fexofenadine (Allegra Allergy)

Gastrointestinal Medications

  • Famotidine (Pepcid)
  • Cimetidine (Tagamet HB)

Antidepressants

  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Fluvoxamine (Luvox)

Can breastfeeding mothers use birth control pills? Yes, progestin-only contraceptives, such as the minipill, are generally considered safe for nursing mothers. Recent research also suggests that combined hormonal contraceptives (containing both estrogen and progestin) may be used one month after childbirth without significantly affecting milk production in otherwise healthy women.

Medications Requiring Caution During Breastfeeding

While many medications are safe for breastfeeding mothers, some require careful consideration and may necessitate adjustments to breastfeeding practices.

Decongestants

Pseudoephedrine-containing medications (e.g., Sudafed, Zyrtec D) should be used with caution, as they can potentially decrease milk supply. Are there alternative decongestants for nursing mothers? Consider consulting with a healthcare provider about nasal sprays or other options that may have less impact on milk production.

High-Dose Vitamins and Herbal Supplements

Breastfeeding mothers should exercise caution with high-dose vitamins and herbal supplements, as their safety profiles during lactation are often not well-established. Is it necessary to avoid all supplements while breastfeeding? Not necessarily, but it’s crucial to consult with a healthcare provider before starting any new supplement regimen.

When to Consider Altering Breastfeeding Practices

In some cases, the use of certain medications may require temporary or permanent changes to breastfeeding routines. How can mothers navigate these situations?

Temporary Cessation of Breastfeeding

If a medication is deemed unsafe for short-term use while breastfeeding, mothers may need to temporarily pause nursing. In such cases, maintaining milk supply is crucial. How can mothers keep up their milk production? Using a double electric breast pump to express milk regularly can help maintain supply until breastfeeding can resume.

Timing Medication Intake

For some medications, adjusting the timing of doses relative to breastfeeding sessions can minimize infant exposure. When is the best time to take medication while breastfeeding? Generally, taking medication immediately after a feeding session allows time for the drug levels in breast milk to decrease before the next feeding.

Permanent Discontinuation of Breastfeeding

While rare, some medications may necessitate permanent cessation of breastfeeding. In such cases, healthcare providers can guide mothers through the weaning process and help select appropriate infant formulas.

Monitoring Infant Health During Maternal Medication Use

When breastfeeding mothers need to take medication, monitoring the infant for any potential side effects is crucial. What signs should mothers watch for in their babies?

  • Changes in feeding patterns or appetite
  • Unusual drowsiness or irritability
  • Skin rashes or other allergic reactions
  • Gastrointestinal disturbances (e.g., diarrhea, constipation)
  • Any other unexpected changes in behavior or health

How often should infants be monitored when mothers start new medications? It’s advisable to pay close attention to the baby’s behavior and health for the first few days after starting a new medication. Any concerns should be promptly discussed with a healthcare provider.

The Importance of Healthcare Provider Consultation

The decision to use medication while breastfeeding should always involve consultation with a healthcare provider. Why is professional guidance so crucial in these situations?

  1. Personalized risk assessment based on maternal and infant health
  2. Consideration of alternative medications or treatments
  3. Guidance on proper dosing and timing of medication intake
  4. Monitoring recommendations for both mother and infant
  5. Up-to-date information on medication safety during lactation

Should mothers consult their healthcare provider before taking any medication while breastfeeding? Yes, it’s advisable to check with a healthcare professional before starting any new medication, including over-the-counter drugs and supplements. This ensures the safest possible approach to managing maternal health while continuing to breastfeed.

Balancing Maternal Health and Infant Nutrition

Making decisions about medication use while breastfeeding often involves weighing the benefits of maternal treatment against potential risks to the infant. How can mothers and healthcare providers navigate this balance?

Assessing the Necessity of Medication

Is the medication essential for the mother’s health and well-being? In many cases, the benefits of treating a maternal condition outweigh the potential risks of medication exposure through breast milk. Untreated maternal health issues can indirectly affect infant care and bonding.

Considering Alternative Treatments

Are there non-pharmacological alternatives that could effectively manage the mother’s condition? In some cases, lifestyle modifications, physical therapy, or other non-drug interventions might be suitable options.

Evaluating Breastfeeding Goals

How important is continued breastfeeding to the mother and infant? Factors such as the baby’s age, overall health, and the availability of suitable alternatives to breast milk should be considered when making decisions about medication use.

Can the benefits of breastfeeding outweigh the potential risks of medication exposure? In many cases, yes. Breast milk provides numerous health benefits to infants, and the advantages of continued breastfeeding often surpass the minimal risks associated with many medications.

Strategies for Minimizing Medication Exposure Through Breast Milk

When medication use is necessary during breastfeeding, several strategies can help minimize infant exposure:

Optimal Timing of Medication Intake

How can mothers time their medication intake to reduce infant exposure? Taking medications immediately after breastfeeding or just before the infant’s longest sleep period can help minimize the amount of drug present in breast milk during feeding times.

Choosing Appropriate Formulations

Do different medication formulations affect breast milk transfer? Yes, some formulations may result in lower drug concentrations in breast milk. For example, topical medications often lead to less systemic absorption compared to oral forms.

Monitoring and Adjusting Dosages

Can medication dosages be adjusted for breastfeeding mothers? In some cases, healthcare providers may recommend lower doses or extended intervals between doses to minimize infant exposure while still effectively treating the maternal condition.

Pumping and Discarding Milk

When is it necessary to pump and discard breast milk? For medications with known high transfer rates or potential toxicity, temporarily pumping and discarding milk during peak drug concentration periods may be advised.

How long should mothers pump and discard milk? The duration depends on the specific medication and its half-life. Healthcare providers can offer guidance based on the drug’s properties and the individual situation.

The Role of Research and Evolving Guidelines

Our understanding of medication safety during breastfeeding continues to evolve as new research emerges. How does this ongoing research impact recommendations for nursing mothers?

Advances in Lactation Pharmacology

What recent developments have improved our understanding of drug transfer to breast milk? Advances in analytical techniques and pharmacokinetic modeling have enhanced our ability to predict and measure drug concentrations in breast milk accurately.

Updated Clinical Guidelines

How often are breastfeeding medication guidelines updated? Professional organizations regularly review and update their recommendations based on the latest research findings. Healthcare providers stay informed about these changes to provide the most current advice to their patients.

The Importance of Postmarket Surveillance

Why is ongoing monitoring of medication effects in breastfeeding dyads crucial? Postmarket surveillance helps identify rare or long-term effects that may not be apparent in initial studies, contributing to a more comprehensive understanding of medication safety during lactation.

How can breastfeeding mothers contribute to this research? Participating in medication registries or reporting any observed effects to healthcare providers can help build a more robust knowledge base for future recommendations.

The intersection of medication use and breastfeeding presents a complex landscape that requires careful navigation. By staying informed, consulting healthcare providers, and considering individual circumstances, nursing mothers can make educated decisions that support both their health and their infants’ well-being. As research in this field continues to advance, we can expect even more refined guidance to emerge, further empowering mothers to make the best choices for themselves and their babies.

Breast-feeding and medications: What’s safe?

Breast-feeding and medications: What’s safe?

Wondering about breast-feeding and medications? Know how medications can affect your breast milk and which drugs are safe to take.

By Mayo Clinic Staff

If you’re breast-feeding, you’re giving your baby a healthy start. However, if you need to take medication, you might have questions about the possible impact on your breast milk. Here’s what you need to know.

Do all medications pass into breast milk?

Almost any drug that’s present in your blood will transfer into your breast milk to some extent. Most medications do so at low levels and pose no real risk to most infants. There are exceptions, though, in which drugs can become concentrated in breast milk. As a result, every medication must be considered separately.

Does my baby’s health and age influence how he or she might be affected by exposure to medication in my breast milk?

Yes. Exposure to medication in breast milk poses the greatest risk to premature babies, newborns, and babies who are medically unstable or have poorly functioning kidneys.

The risk is lowest for healthy babies 6 months and older, who can move drugs through their bodies efficiently. Women who breast-feed more than one year after childbirth often make relatively smaller quantities of milk. This reduces the amount of medication transferred to breast milk. Also, medications used in the two days after childbirth transfer at very low levels to your infant due to the limited volume of breast milk you produce during this time.

Should I stop breast-feeding while taking medication?

Most medications are safe to take while breast-feeding. Also, the benefit of continuing to take a medication for a chronic condition while breast-feeding often outweighs any potential risks.

Still, a few medications aren’t safe to take while breast-feeding. If you’re taking a medication that could be harmful to your baby, your health care provider might recommend an alternative medication. Or he or she might recommend breast-feeding when the medication is at a low level in your breast milk.

Sometimes your health care provider might recommend that you stop breast-feeding temporarily or permanently — depending on how long you need to take the medication. If you have advance notice, pump in addition to breast-feeding and store expressed milk for use during that time. If you need to stop breast-feeding only temporarily, use a double electric breast pump to keep up your milk supply until you’re able to breast-feed again. Discard the milk you pump while you’re taking the medication.

If you’re not sure if a medication is compatible with breast-feeding, pump, label and store expressed breast milk in a separate area until you check with your health care provider. If you need to stop breast-feeding permanently — which is unusual — ask your health care provider about weaning and to help you choose an infant formula.

What medications are safe to take while breast-feeding?

With your health care provider’s input, consider this list of medications found to be safe during breast-feeding. Keep in mind that this isn’t a comprehensive list of safe medications.

Pain relievers
  • Acetaminophen (Tylenol, others)
  • Ibuprofen (Advil, Motrin IB, others)
  • Naproxen (Naprosyn) — short-term use only
Antimicrobial medications
  • Fluconazole (Diflucan)
  • Miconazole (Monistat 3) — apply minimal amount
  • Clotrimazole (Mycelex, Lotrimin) — apply minimal amount
  • Penicillins, such as amoxicillin and ampicillin
  • Cephalosporins, such as cephalexin (Keflex)
Antihistamines
  • Loratadine (Claritin, Alavert, others)
  • Fexofenadine (Allegra Allergy)
Decongestants
  • Medications containing pseudoephedrine (Sudafed, Zyrtec D, others) — use with caution because pseudoephedrine can decrease milk supply
Birth control pills
  • Progestin-only contraceptives, such as the minipill

Recent research suggests that birth control methods that use both estrogen and progestin — such as combined birth control pills — don’t affect milk production. For otherwise healthy women, it’s OK to begin using combined birth control pills and other types of combined hormonal birth control one month after childbirth.

Gastrointestinal medications
  • Famotidine (Pepcid)
  • Cimetidine (Tagamet HB)
Antidepressants
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Fluvoxamine (Luvox)
Constipation medications
  • Docusate sodium (Colace, Diocto)

Do I need my health care provider’s OK ahead of time?

If you’re breast-feeding and plan to take medication, check with your health care provider. Avoid taking unnecessary medications, such as herbal medications, high-dose vitamins and unusual supplements.

Also ask about the timing. For example, taking medication immediately after breast-feeding might help minimize your baby’s exposure. However, different drugs peak in breast milk at different times.

What if my baby has a reaction?

When you’re taking medication, watch your baby for any changes in eating or sleeping habits, fussiness, or a rash. If you notice any change in your baby’s behavior, contact his or her doctor.

July 31, 2020

Show references

  1. Kaunitz AM. Postpartum contraception: Initiation and methods. https://www.uptodate.com/contents/search. Accessed June 26, 2018.
  2. Sachs HC. The transfer of drugs and therapeutics into human breast milk: An update on selected topics. Pediatrics. 2013;132:e796.
  3. Kimmel MC, et al. Safety of infant exposure to antidepressants and benzodiazepines through breastfeeding. https://www.uptodate.com/contents/search. Accessed June 26, 2018.
  4. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 92: Use of Psychiatric Medications During Pregnancy and Lactation. Obstetrics & Gynecology. 2008;111:1001. Reaffirmed 2014.
  5. Wambach K, et al., eds. Drug therapy and breastfeeding. In: Breastfeeding and Human Lactation. 5th ed. Sudbury, Mass.: Jones and Bartlett Learning; 2016.
  6. Briggs GG, et al. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. 11th ed. Philadelphia, Pa.: Wolters Kluwer; 2017. http://ovidsp.tx.ovid.com/. Accessed June 26, 2018.
  7. Drugs and Lactation Database (LactMed). U.S. National Library of Medicine. https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm. Accessed June 26, 2018.

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Keeping breast milk safe and healthy

Can what you eat and drink affect your breast milk?

Yes. Nutrients in foods and drinks help make your breast milk healthy. When you’re breastfeeding, eat healthy foods, like fruits, vegetables, whole-grain breads and lean meats. Eat fewer sweets and salty snacks. You may need 450 to 500 extra calories a day when you’re breastfeeding to make breast milk for your baby. 

Drink lots of water. It’s important to stay hydrated (have fluid in your body) when you’re breastfeeding. Drink when you’re thirsty. A simple way to make sure you drink enough water is to have a glass each time you breastfeed.

Limit caffeine when you’re breastfeeding. Caffeine is a drug that’s found in things like coffee, tea, soda, energy drinks, chocolate and some energy drinks and medicines. Too much caffeine in breast milk can make your baby fussy or have trouble sleeping. If you drink coffee, have no more than two cups a day while you’re breastfeeding. 

Do you need to take vitamins or supplements when you’re breastfeeding?

Yes. Food is the best source of nutrients. But even if you eat healthy foods every day, you may not get all the nutrients you need. So you may need a little help from supplements. A supplement is a product you take to make up for certain nutrients that you don’t get enough of in food. For example, you may take a vitamin supplement to help you get more vitamin B or C. Or you may take an iron or calcium supplement. 

When you’re breastfeeding, take a multivitamin every day or keep taking your prenatal vitamin. A multivitamin contains many vitamins (like vitamins B and C and folic acid) and minerals (like iron and calcium) that help your body stay healthy. A prenatal vitamin is a vitamin made for pregnant women. Don’t take any vitamin or supplement without talking to your provider first. 

Here are some nutrients you may need supplements for during breastfeeding:

DHA. DHA stands for docosahexaenoic acid. It’s a kind of fat (called omega-3 fatty acid) that helps with growth and development. If you’re breastfeeding, you need 200 to 300 milligrams of DHA each day to help your baby’s brain and eyes develop. You can get this amount from foods, like fish that are low in mercury, like herring, salmon, trout, anchovies and halibut. Or you can get it from foods that have DHA added to them, like orange juice, milk and eggs. If you don’t get enough DHA from food, you can take a DHA supplement. Talk to your provider to make sure you get the right amount of DHA each day.

Iodine. When you’re breastfeeding, you need 290 micrograms of iodine each day. Iodine in your breast milk helps your baby’s body make thyroid hormones that help his bones and nerves develop. You may not get enough iodine from food you eat. And not all multivitamins and prenatal vitamins contain iodine. So talk to your provider to make sure you’re getting enough iodine each day. You can get iodine by:

  • Eating foods that are high in iodine, like fish, bread, cereal and milk products
  • Taking an iodine or iodide supplement. Iodide is a form of iodine.
  • Using iodized salt. This is salt that has iodine added to it. Read the package label to make sure your salt is iodized.

Vitamin B12. Vitamin B12 in your breast milk supports your baby’s brain development and helps him make healthy red blood cells. You can get vitamin B12 from foods, like meat, fish, eggs, milk and products made from milk. Or you may need a supplement. Ask your provider about taking a vitamin B12 supplement to make sure you and your baby get the right amount. You may need extra vitamin B12 if you:

  • Are a strict vegetarian or vegan. A vegetarian is someone who doesn’t eat meat and mostly east foods that come from plants. A vegan is someone who doesn’t eat meat or anything made with animal products, like eggs or milk.
  • Have had gastric bypass surgery. This is surgery on the stomach and intestines to help you lose weight.
  • Have digestive conditions, like celiac disease or Crohn’s disease. These conditions affect how your body digests (breaks down) food. 

Don’t take herbal products, like ginkgo or St. John’s wort, when you’re breastfeeding. Herbal products are made from herbs. Herbs are plants used in cooking and medicine. Even though herbs are natural, they may not be safe for your baby. It’s best not to use these products while you’re breastfeeding. 

Can smoking while breastfeeding hurt your baby?

Yes. Don’t smoke if you’re breastfeeding. Nicotine is a drug found in cigarettes. It passes to your baby in breast milk and can cause problems, like: 

  • Making your baby fussy
  • Making it hard for your baby to sleep
  • Reducing your milk supply so your baby may not get all the milk he needs 

Secondhand smoke also is bad for your baby. Secondhand smoke is smoke from someone else’s cigarette, cigar or pipe. It can cause lung and breathing problems. Babies of mothers who smoke are more likely than babies of non-smokers to die from sudden infant death syndrome (also called SIDS). SIDS is the unexplained death of a baby younger than 1 year old.

If you do smoke, it’s OK to breastfeed. But smoke as little as possible and don’t smoke around your baby.

Can you pass alcohol or street drugs to your baby through breast milk?

Yes. Don’t drink alcohol when you’re breastfeeding. Alcohol includes beer, wine, wine coolers and liquor. If you do drink alcohol, don’t have more than two drinks a week. Wait at least 2 hours after each drink before you breastfeed.

You also can pass street drugs, like heroin and cocaine, to your baby through breast milk. Tell your health care provider if you need help to quit using street drugs. 

If you’re breastfeeding, don’t use marijuana. It’s not safe for your baby. You may pass THC and other chemicals from marijuana to your baby through breast milk. If you breastfeed your baby and smoke marijuana, your baby may be at increased risk for problems with brain development. Marijuana also may affect the amount and quality of breast milk you make. Even if marijuana is legal to use in your state, don’t use it when you’re breastfeeding. 

Are prescription medicines safe to take when you’re breastfeeding?

Some are, and some aren’t. A prescription medicine (drug) is one your provider says you can take to treat a health condition. You need a prescription (an order from your provider) to get the medicine. Some prescription drugs, like medicine to help you sleep, some painkillers and drugs used to treat cancer or migraine headaches, aren’t safe to take while breastfeeding. Others, like certain kinds of birth control, may affect the amount of breast milk you make. 

Here’s what you can do to make sure prescription medicine you take is safe for your baby when you’re breastfeeding:

  • Talk to your health care provider and your baby’s provider about breastfeeding before your baby is born. Tell each provider about any medicine you take. If you take a medicine that’s not safe for your baby, your provider may switch you to a safer one. Don’t start or stop taking any medicine during breastfeeding without talking to your providers first.
  • Make sure any provider who prescribes you medicine knows that you’re breastfeeding.
  • Check with your provider even if you take medicine that’s usually prescribed for your baby, like baby aspirin.
  • Tell your baby’s provider if your baby has any signs that may be a reaction to your medicine, like diarrhea, sleepiness, a change in eating or crying more than usual. 

If you have a chronic health condition and you plan to breastfeed, talk to your providers about how your condition affects breastfeeding. You most likely can breastfeed even with a chronic health condition. Your provider can help you make sure that any medicine you take is safe for your baby. A chronic health condition is one that lasts for 1 year or more. It needs ongoing medical care and can limit a person’s usual activities and affect daily life. Examples are diabetes, high blood pressure, obesity and depression. Chronic health conditions need treatment from a health care provider.

Is it safe to take prescription opioids when you’re breastfeeding?

Prescription opioids are painkillers your provider may prescribe if you’ve been injured or had surgery or dental work. They’re sometimes used to treat a cough or diarrhea. If you had an episiotomy or a cesarean birth (also called a c-section), your provider may prescribe an opioid like codeine or tramadol to help relieve your pain. An episiotomy is a cut made at the opening of the vagina to help let your baby out. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb).

Opioid use during pregnancy is the most common cause of neonatal abstinence syndrome (also called NAS). NAS is a group of conditions caused when a baby withdraws from certain drugs she’s exposed to in the womb before birth. If your baby has NAS, breastfeeding may help make her symptoms less severe. This may help her need less medicine and be able to leave the hospital sooner. If your baby has NAS, talk to your provider and your baby’s provider about breastfeeding and how to make sure it’s safe for your baby. 

If you’re using prescription opioids with your provider’s supervision, you can breastfeed depending on the opioid you take. Some opioids can cause life-threatening problems for your baby. Make sure the provider who prescribes you the opioid knows you’re breastfeeding, and take the medicine exactly as our provider tells you to. If you take any of these opioids, talk to your provider about switching to a safer medicine:

  • Codeine or medicines that contain codeine
  • Hydrocodone
  • Meperidine
  • Oxycodone
  • Tramadol

If you’re in treatment for opioid use disorder with medicines like methadone or buprenorphine (also called medication-assisted therapy or MAT or opioid-assisted therapy or OAT), you can breastfeed your baby if:

  • Your health is stable and you’re no longer misusing opioids or using street drugs, like cocaine or marijuana.
  • You don’t have HIV (stands for human immunodeficiency virus. HIV is the virus that causes AIDS (stands for acquired immunodeficiency syndrome).
  • Your treatment is closely supervised and monitored.
  • You have social support from friends and family throughout your treatment.
  • Your baby continues to gain weight as you breastfeed.  

If you’re breastfeeding and taking tramadol, codeine or medicines that contain codeine, call your baby’s provider or emergency services (911) right away if your baby:

  • Is sleepier than usual. Breastfed babies usually eat every 2 to 3 hours and shouldn’t sleep more than 4 hours at a time.  
  • Is limp
  • Has trouble breathing
  • Has trouble breastfeeding

To find out more about prescription medicines and breastfeeding, visit LactMed. 

Are over-the-counter medicines safe to take when you’re breastfeeding? 

Most over-the-counter (also called OTC) medicine, like pain relievers and cold medicine, are OK to take when you’re breastfeeding. For example, OTC pain relievers like ibuprofen (Advil®) or acetaminophen (Tylenol®) are safe to use when breastfeeding. 

Here’s what you can do to help make sure an OTC medicine is safe for your baby:

  • Don’t take an OTC medicine during breastfeeding without talking to your provider first. If you take a medicine that’s not safe for your baby, your provider can recommend a safer one.
  • Read the label on the package for information about how an OTC drug may affect breastfeeding.
  • Take the smallest dose (amount) of medicine to help lessen the amount that gets passed to your baby in breast milk.
  • Don’t take medicine that is extra-strength, long-acting (you take it just once or twice a day) or multi-symptom (treats more than one symptom). These medicines may have larger doses that stay in your body and breast milk longer than medicines with smaller doses.  
  • Tell your baby’s provider if your baby has signs of reaction, like diarrhea, sleepiness, a change in eating, or crying more than usual.

To find out more about OTC medicines and breastfeeding, visit LactMed. 

What medical conditions make breastfeeding unsafe for your baby?

Breastfeeding may be harmful to a baby if:

  • Your baby has galactosemia. Babies with this genetic condition can’t digest the sugar in breast milk (or any kind of milk). They can have brain damage or even die if they eat or drink breast milk, milk or anything made with milk. Babies with galactosemia need to eat a special formula that is not made with milk of any kind. Your baby gets tested for this condition soon after birth as part of newborn screening.
  • You have HIV. You can pass HIV to your baby through breast milk.
  • You have cancer and are getting treated with medicine or radiation.
  • You have human T-cell lymphotropic virus. This is a virus that can cause blood cancer and nerve problems.
  • You have untreated, active tuberculosis. This is an infection that mainly affects the lungs.
  • You have Ebola, a rare but very serious disease that can cause heavy bleeding, organ failure and death. It’s spread by coming in contact with body fluids from a person who has the disease. A mother who has Ebola should not have close contact—including breastfeeding—with her baby. This can help keep her baby safe from the disease. While the virus has been found in breast milk, we don’t know for sure if you can pass Ebola to your baby through breast milk.  

If you’ve had breast surgery or piercing, it’s most likely safe to breastfeed. Breast surgery includes getting implants, having a breast reduction or having a lump removed. Piercing means inserting jewelry into the breast, including nipple piercing. If you’ve had surgery or piercing, talk to your provider or lactation consultant. A lactation consultant is a person with special training in helping women breastfeed. 

If you’ve been exposed to lead, is it safe to breastfeed?

It depends on the amount of lead you have in your body. Lead is a metal that comes from the ground, but it can be in the air, water and food. You can’t see, smell or taste it. High levels of lead in your body (called lead poisoning) can cause serious health problems. 

If you think you’ve been exposed to lead and are breastfeeding or planning to breastfeed, tell your provider. She can test your lead levels to see if breastfeeding is safe for your baby. If you have more than 40 micrograms/dL of lead in your system, it’s not safe to breastfeed. Pump your breast milk and throw it out until your lead levels are safe. 

More information

Last reviewed: March, 2019

See also: Feeding your baby in the NICU, Prescription opioids during pregnancy, Vitamins and other nutrients during pregnancy

Cold and Allergy Remedies Compatible with Breastfeeding • KellyMom.com

The common cold will usually run its course within 7 to 14 days. There are many natural remedies and over the counter products that are compatible with breastfeeding.

Image credit: Jerry Bunker on flickr

Natural Remedies

General

  • Rest. Drink lots of water and take hot baths. Run a humidifier.
  • Take in extra vitamin C from foods, juices or in supplement form.
  • Echinacea is generally recognized to be safe for nursing moms.
  • Garlic eaten raw, cooked, or taken as a supplement can help. Raw is always best, though it’s hardest to get down.
  • OMT is a very gentle form of osteopathic manipulation, which can enhance the immune system, and help keep the fluids draining from the head and neck so bacteria and viruses are less likely to be able to grow. This can help to reduce or even prevent chronic ear and respiratory infections. OMT has been shown to have a dramatic effect on fluid in the ears, and works well on any type of upper respiratory infection.

Head congestion

  • Use a saline nasal spray
  • Steam treatments:
    • Boil a pot of water, remove from the stove and (optional) add a few drops of essential oils (for example: eucalyptus, sage and balsam). Drape a bath towel over your head and breathe deeply for 5 minutes. Do this 2 or 3x a day until symptoms subside.
    • Put two inches of apple cider vinegar in a pan and heat until it begins to steam. Inhale the vapor. If the vapor is too strong, add a little water. Repeat as needed.
  • Essential Oils: Place a drop or two of either eucalyptus or peppermint essential oil on a cotton ball or handkerchief and hold near the nose while breathing deeply.
    • A couple of cautions: Do not use the oil in the nose – it can cause swelling. Do not use peppermint oil or menthol (one of the main components in peppermint oil) or camphor on or near the breast where baby might ingest it, and do not apply directly on the skin of a baby or young child. There have been cases where the direct application of menthol or camphor products (for example, Vicks VapoRub™) to baby’s skin resulted in severe breathing difficulties or liver problems (see info on colds and congestion in baby).
  • Cayenne pepper: Sprinkle it on your food, or put a quarter teaspoon in a glass of water and drink.
  • Drink fenugreek tea to relieve head and chest congestion and cough.
  • What To Do When You Have Sinus Pain by Allison Ishman

Chest congestion

  • Anise steam treatment: Boil a pot of water, remove from the stove and add about 3 teaspoons of dried anise. Drape a bath towel over your head and breathe deeply for 5 minutes. Do this 3x a day to help keep the chest clear.
  • Drink fenugreek tea to relieve head and chest congestion and cough.

Sore, itchy throat and/or cough

  • Drink strong black tea (use 2 tea bags per cup).
  • Drink hot lemonade with honey. Or make a mixture of one part lemon juice and two parts honey. Sip throughout the day.
  • Drink fenugreek tea to relieve head and chest congestion and cough.
  • Use Zinc gluconate lozenges, but avoid taking large amounts of zinc for more than seven days, because it can interfere with other minerals in the body.
  • Salt water gargle:
    Mix a 1 tablespoon of salt in eight ounces of warm water. Gargle the whole mixture (don’t swallow) several times a day.
  • Apple-cider vinegar and water gargle.
    Mix 1-6 teaspoons (1/3 – 2 tablespoons) vinegar in a glass of water; you can mix it as strong as you can stand it. Gargle one mouthful (swallow afterward or spit it out). Repeat twice. Do this every hour, or as needed.
  • Slippery elm bark can help with sore throat and cough. It comes in herbal cough drops and throat lozenges (check the other ingredients!), or you can make a tea. For tea, use 1 to 3 teaspoons of powdered bark per cup, boil and simmer 15 minutes. Up to 3 cups per day.
  • Chamomile tea gargle (you can also drink the tea)

Medications generally regarded as safe

General guidelines

  • Treat only the symptoms you have: avoid a combination medicine when a single one will do the job.
  • Short-acting forms of drugs (6 hours or less) are generally better than the long-acting varieties (but see the info below on the nonsedating antihistamines).
  • Use nasal spray instead of oral medications when possible (see below).
  • Take any medication right AFTER you nurse and only as needed.

The current edition of Medications and Mothers’ Milk by Thomas Hale, PhD has information on many cold medications (including specific guidance on combination products) in the Appendix. Many of the active ingredients in cold and allergy medications are listed below.

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Cough & sore throat meds

  • Sore throat sprays or lozenges are generally considered safe, as are cough drops. Avoid eating excessive amounts of cough drops containing menthol. Large amounts of menthol can reduce milk supply.
  • Many forms of Robitussin, Delsym and Benylin are considered compatible with breastfeeding. Always check the active ingredients, as there are many versions.

 

Pain meds

Both Advil/Motrin (Ibuprofen) and Tylenol (Acetaminophen) are considered compatible with breastfeeding.

Aleve (Naproxen) is also AAP-approved for nursing mothers, but (per Hale) should be used with caution due to its long half-life and its effect on baby’s cardiovascular system, kidneys and GI tract; short-term, infrequent or occasional use is not necessarily incompatible with breastfeeding.

Aspirin use is discouraged in children due to the risk of Reye’s syndrome.  Although the risk is probably low, it is also discouraged in nursing mothers because of the potential risk of Reye’s syndrome and bleeding.

 

Eye drops

Eye drops designed for cold/allergy symptom relief are considered compatible with breastfeeding.

 

Nasal sprays or gels

Nasal sprays are generally considered compatible with breastfeeding.

Decongestant nasal sprays are generally for short-term use (3-7 days) only; consult your health care provider and the package instructions for specific information.

Of the preparations available for treatment of allergic symptoms, corticosteroid nasal sprays (e.g., Flonase, Nasacort, etc.) and cromolyn sodium nasal spray (a mast cell stabilizer, e.g., Nasalcrom) are considered to be, by far, some of the most effective and safest to use in breastfeeding moms. The plasma levels of these drugs are extremely low, and thus milk levels would be even lower.

A homeopathic nasal gel, made by Zicam and containing ionic zinc gluconate, was recalled by the US FDA in 2009 because it has been associated with long lasting or permanent loss of smell (anosmia) [this is not related to lactation – see the FDA information page and Jafek BW, Linschoten MR, Murrow BW. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004 May-Jun;18(3):137-41]. Zicam contains small amounts of zinc (Zincum Gluconicum) – 266 micrograms per squirt; in one study (Mossad 2003) the daily dosage used was 2.1 mg per day. Zinc is considered compatible with breastfeeding, particularly in small amounts (excessive amounts are not a good idea, for mom’s sake rather than baby’s). The amount of systemic absorption of nasal sprays/gels is minimal compared to oral ingestion.

 

Decongestants

Both pseudoephedrine and phenylephrine are generally considered to be safe for the breastfed baby, but pseudoephedrine may reduce milk supply.

Pseudoephedrine & milk supply: Thomas Hale Ph. D., a renowned breastfeeding pharmacologist (Breastfeeding Pharmacology), notes that “breastfeeding mothers with poor or marginal milk production should be exceedingly cautious in using pseudoephedrine” and that “it is apparent that mothers in late-stage lactation may be more sensitive to pseudoephedrine and have greater loss in milk production” (Medications and Mother’s Milk, 2012 edition).

Dr. Hale is referring to this study: Aljazaf K, et. al. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol. 2003 Jul;56(1):18-24.

If you do take pseudoephedrine and notice a drop in milk supply (many moms do not, but research shows that it can decrease milk supply by as much as 24%), simply stop the medication and take measures to increase milk supply – the problem should resolve fairly quickly.

Be very cautious about taking pseudoephedrine on a regular basis, as it has the potential to permanently decrease your milk supply. Regular use of pseudoephedrine (120 mg/day) has occasionally been used to decrease milk production in moms with overproduction, where the usual methods to regulate milk production were not working.

 

Antihistamines

Mom’s use of sedating antihistamines (including Benadryl and Chlor-Trimeton products) are generally regarded to be compatible with breastfeeding, but always double-check the active ingredients as they can vary greatly. Monitor your infant for possible drowsiness if you use this type of antihistamine. The non-sedating antihistamines (below) are generally preferred and are less likely to sedate baby.

The ingredients of Claritin, Claritin-D, Clarinex, Allegra, Allegra-D, and Zyrtec are generally regarded to be compatible with breastfeeding (again – always double-check the active ingredients). Loratadine (Claritin) has been studied and the amount of loratadine that passes into breastmilk is extremely low. Claritin-D and Allegra-D have the decongestant pseudoephedrine added (see above about possible effect on milk supply). Dr. Hale has said that he prefers the non-sedating antihistamines (even though they are long-acting) over the sedating allergy medications.

Milk supply: A common concern is that the sedating antihistamines might lower milk supply but, per Dr. Thomas Hale, there is no current research supporting this belief – only some anecdotal reports. If you feel that your supply has decreased, it could simply be a byproduct of decreased nursing frequency or dehydration due to your illness.

If you feel that a medication is the cause of a sudden drop in milk supply, then stop taking (or decrease your use of) the medication – if the med is indeed the cause, then supply should increase again soon after you stop taking it. When using an antihistamine, it can be helpful to step up your fluid intake quite a bit. As with any medication, take it only as needed, and discontinue use as soon as you can.

 

Links for additional information

General

Natural Remedies

Medications

Cold Remedies for Nursing Moms

Colds are never fun and trying to mother with a cold can be downright difficult. If you are not feeling well with runny nose and cough, lots of fluids and rest is always a good recipe for getting back to normal. Cold symptoms last 6-10 days with symptoms peaking on day 4-5 and subsiding by day 7-10. If your symptoms are worsening by 7 days into a cold, you should see your doctor. If you run a fever beyond 3-4 days, medical care should be sought. Flu-like symptoms are not a normal part of a common cold and may be indicative of a breast infection or other illness. Consult your physician if you experience these. Otherwise rest and sleep when baby sleeps.

If you are ill and not feeling well, you may inadvertently skip feedings or feel the need for someone else to feed your baby. This may cause a decrease in your milk supply. To maintain your supply, make sure you get plenty of rest, drink fluids, and continue to eat three meals a day and three snacks. It is safe to continue to breastfeed even when you are ill unless your doctor advises otherwise. Your body will produce antibodies that pass into your milk and protect your infant from your infection. Breastfed babies do experience illness and can pick up illness from others in their household but generally, the breastfed babies illness is less severe than formula fed infants and the infant recovers from illness sooner.

Medication

Tylenol, or acetaminophen and Advil,or ibuprofen are approved for use while breastfeeding. Benadryl and other allergy medications may reduce your milk supply and also may make the baby drowsy. Antihistamines and decongestants, including Dimetapp and Sudafed, are not recommended while breastfeeding, as they may substantially decrease your milk supply. See Dr Thomas Hale’s website for a thorough discussion on medications and breastfeeding. While Benadryl and older versions of antihistamines are not recommended because they may decrease milk supply, Zyrtec and Claritin are OK.

Vaporizers

Vaporizer with plain water may be beneficial in moistening the nasal passages and helping to clear the airway. Menthol products in a vaporizer should be avoided and have been identified as an irritant in nasal passages in infants.

Zinc

Zinc Gluconate,as found in Cold-eeze and Zicam is considered safe with breastfeeding although the nasal gel is recommended over the oral drops. According to Thomas Hale, PhD, “Zinc is an essential mineral that is required for your cell’s enzymatic functions and the recommended daily allowance for adults is 12-15 mg per day. While zinc does enter the breastmilk, growing newborns require zinc and as long as supplementation does not exceed 25-50 mgs per day,….avoid zinc sulfates because those have been shown to be detrimental to proper immune system function.”

Neti Pot

A Neti Pot is recommended for people with allergies or sinus problems, and works to clear the nasal passages during the common cold. Since it only uses water and the mother is not actually ingesting anything, it is very safe for a nursing mom.

Flu

Seasonal flu treatment includes either Oseltamivir (Tamiflu) or zanamivir (Relenza). These antivirals work early on in the illness and are not indicated if fever and illness has been present for more than 48 hours. The CDC considers oseltamivir safe to use in breastfeeding mothers. At present, there is no breastfeeding data on zanamivir (Relenza). Physicians are advised to use oseltamivir (Tamiflu) instead of zanamivir (Relenza) in breastfeeding mothers.

Herbal Remedies

Many herbal remedies and their safety have not been evaluated for the breastfeeding infant. Just because a product is marked natural does not mean it is safe while breastfeeding. Caution should be used for any consumption of herbals as well as prescribed medications. If insufficient data is available on a specific herbal remedy then it is advised to avoid it while breastfeeding. Insufficient data is available for Airborne, a cold remedy, and therefore should be avoided for breastfeeding mothers.

Beverly Curtis is a former Kids Plus provider.

Medications that can be taken while breastfeeding

Medications that can be taken while breastfeeding

Now that you’ve had your baby, you may be wondering what medications you can take if you get sick. For the most part, the same medications that you used when pregnant can be used safely while breastfeeding. We have provided a list of over-the-counter medications that are considered to be safe for a woman to take while breastfeeding. If your symptoms are not relieved after taking a medication from this list, or you wish to take a medication not on this list, please call our office for further assistance.

 Allergies

◊ The American Academy of Pediatrics considers these medications to be safe & effective for breastfeeding women to use, however it is important to note that they may affect milk supply. Some women who take decongestants find that there is a decrease in the amount of milk their bodies produce. If you notice a decrease in milk supply you should stop taking decongestants.

  • Claritin
  • Benadryl
  • Actifed
  • Sudafed (requires a prescription)
  • Sudafed PE
  • Chlortrimeton

 

 Artificial Sweeteners

 

Constipation

  • Colace
  • Fibercon
  • Metamucil
  • Citrucel
  • Milk of Magnesia


Coughs & Colds

  • Robitussin PE or Robitussin DM
  • Tylenol Sinus
  • Vicks Vapo-Rub
  • Cough Drops

 

Heartburn / Indigestion

  • Mylanta
  • TUMS
  • Pepcid
  • Maalox
  • Gavison
  • Pepto Bismol

Hemorrhoids

  • Preparation H
  • Anusol HC
  • Tucks

 

Nasal congestion

◊ See note in “Allergy” section above.

  • Robitussin CF
  • Actifed
  • Sudafed
  • Saline Nasal Spray

 

Pain, Fever, or Headache

  • Tylenol—regular or extra strength
  • NSAIDS (i.e. Ibuprofen, Motrin, or Aleve)

 

Rash / Itching

  • Calamine lotion
  • Benadryl
  • Benadryl Lotion
  • Hydrocortisone cream 1%

 

Skin Care

  • Pro-Active
  • Stridex pads
  • Clearasil
  • Antibacterial Soap
  • Facials

 

Sleep Aid

  • Benadryl
  • Tylenol PM
  • Unisom

 

Sore Throat

  • Cepacol
  • Chloraseptic Spray
  • Throat lozenges or Cough drops

 

Yeast Infection

 

 

 

 

 

Breastfeeding and Over-the-Counter Pain Medicine

Pain after childbirth and during the postpartum period is very common as your body recovers from pregnancy and delivery. It’s especially common to have some pain during the first few days and weeks after you have your baby if you have a c-section or an episiotomy. Afterpains, headache, or sore breasts can also cause discomfort.

If you’re breastfeeding, you may be wondering if you could or should take something to ease the pain. Here’s what you need to know about the safety of taking over-the-counter painkillers while you’re breastfeeding.

Motrin and Advil

Motrin and Advil are brand names for the medication known as ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can bring down an elevated temperature, reduce swelling in the body, and relieve pain.

Uses

Ibuprofen is best known as an over-the-counter medication for the treatment of fever, muscle pain, and headaches. Doctors also prescribe it for many uses.

Motrin is one of the most prescribed medications for pain relief after childbirth.

Ibuprofen is used to treat the pain and discomfort associated with uterine contractions (afterpains), an episiotomy, or a c-section. Additionally, it can help to relieve the pain of engorged breasts, plugged milk ducts, mastitis, and sore nipples. Ibuprofen is also used to treat infants and children. Your child’s pediatrician may prescribe ibuprofen if your baby gets sick or develops a fever. (If your baby is less than 6 months old, ask your doctor before giving OTC ibuprofen.)

Safety When Breastfeeding

Motrin and Advil are considered safe for breastfeeding moms to use. Actually, ibuprofen is probably the best medication to choose for pain relief while you’re breastfeeding. Even though this medication does enter into the breast milk, the amount that passes through to the baby is so small that it is nearly undetectable. This small amount would only be a fraction of the average dose that your child’s health care provider would prescribe to your baby for the treatment of a fever.

Motrin is also a preferred pain medication for nursing women because, unlike narcotic medications, ibuprofen will not make you or your baby sleepy.

Dosage

The recommended adult dose of ibuprofen is 200 to 400 milligrams every four to six hours. However, talk to your doctor before taking any medications, and always follow your doctor’s recommendations.

Side Effects and Warnings

Ibuprofen is a safe medication with almost no side effects reported. However, even with the safest medications, there are always side effects that you should watch out for.

  • If you experience nausea, dizziness, or stomach pain, contact your doctor.
  • If your baby develops diarrhea or vomiting, stop taking ibuprofen and contact your baby’s doctor right away.

Tylenol

Tylenol is the brand name for the medication known as acetaminophen. Acetaminophen is an analgesic and an antipyretic. Analgesics relieve pain, and antipyretics are used to bring down an elevated body temperature.

Uses

Tylenol is a prescription medication, but it is also available over-the-counter. It is commonly used to treat pain, headache, and fever. After childbirth, acetaminophen is often prescribed to help relieve postpartum pain.

Additionally, it can treat the discomfort associated with some of the common problems of breastfeeding including sore nipples, breast engorgement, plugged milk ducts, and mastitis. Tylenol is also used to treat mild pain and fever in infants and children.

Safety When Breastfeeding

It is considered safe to take Tylenol when you are breastfeeding. A small amount of this medication does transfer into breast milk, but healthy, full-term newborns can handle it very well.

Dosage

The recommended adult dose of Tylenol is 325 milligrams to 650 milligrams every four to six hours. However, you should always consult your doctor for proper dosing instructions before taking any medication.

Side Effects and Warnings

Always discuss the use of any medication with your physician before starting it, especially if you or your child have any health issues or if your child is born prematurely. The excessive use of Tylenol can be dangerous. Tylenol should not be taken in large doses or for more than a few days unless your doctor instructs you otherwise.

When the recommended doses of acetaminophen are used, side effects are uncommon.

However, as with all medications, side effects are possible. In nursing mothers, diarrhea, abdominal issues, and liver toxicity have been noted when Tylenol is taken in high doses or when it is taken regularly over a long period of time.

And, although rare, if a mother takes more Tylenol than is recommended, their child may develop stomach problems, diarrhea, rash, or liver problems. If any side effects are suspected, stop taking Tylenol immediately and contact your doctor and your baby’s doctor right away.

Aleve and Naprosyn (Naproxen)

Aleve, Naprosyn, and Anaprox are the brand names for the medication known as naproxen. Naproxen is an NSAID that can relieve pain and reduce a temperature. However, naproxen stays active in the body longer than other NSAIDs and is not generally recommended for postpartum use. In a pinch, a single dose is safe, but it is not routinely used.

Uses

Naproxen is used to bring down a fever and to treat pain, muscle aches, and inflammation in the body.

Safety When Breastfeeding

Naproxen is considered safe for occasional or short-term use during breastfeeding. The transfer of the medication into breast milk is low.

Since naproxen could potentially cause side effects in the baby, it should not be used more than occasionally and not longer than one week. If possible, ibuprofen is a better choice for pain relief while you’re breastfeeding.

Dosage

The recommended adult dose of naproxen is 220 milligrams to 440 milligrams two times a day or every 12 hours. However, you should consult your doctor before taking any medication when you’re breastfeeding.

Side Effects and Warnings

Discuss the use of naproxen with your doctor. Adult side effects of naproxen include stomach upset, heartburn, headache, nausea, dizziness, ringing in the ears, and rash.

  • Stop using naproxen if it causes any drowsiness in your baby.
  • Watch the baby for stomach issues such as vomiting and diarrhea.
  • In one case report, naproxen was linked to bleeding and anemia in a 7-day-old infant.

Aspirin (Acetylsalicylic Acid)

Aspirin is the common name for the medication known as acetylsalicylic acid (ASA). Aspirin is an analgesic that can help to relieve pain. However, it is not recommended for breastfeeding mothers.

Uses

Aspirin is one of the most commonly used pain relievers. It is taken to relieve headaches, muscle aches, and joint pain. It can also help prevent the blood from clotting and lower the risk of heart attack or stroke.

Safety When Breastfeeding

Aspirin is associated with Reye’s syndrome in infants and children when it’s given directly to a child. Pediatricians advise against its use in breastfeeding moms. The potential for Reyes and the availability of safer alternatives make its use undesirable when breastfeeding. Motrin or Tylenol are the preferred choices for pain relief for breastfeeding moms.

Dosage

The recommended adult dose of aspirin for pain relief is 325 milligrams to 650 milligrams every four to six hours. Adults on low-dose aspirin therapy may take 81 milligrams a day. Newborns, infants, and children should not take aspirin.

Aspirin is also not recommended for people with certain health conditions, so be sure to consult your doctor before using it.

Side Effects and Warnings

The availability of safer alternatives makes the use of aspirin undesirable for breastfeeding mothers. Aspirin also can thin out your blood and increase your risk of bleeding. Large doses or the overuse of aspirin in adults can cause gastric upset, ulcers, anemia, and other health problems. It can also cause problems for your baby.

Aspirin is associated with Reye’s syndrome in children who have a viral illness, so it should not be used if the baby is sick with a virus such as the flu. Although rare, aspirin can cause bruising on the baby’s skin or blood in the urine or poop.

A Word From Verywell

Everybody handles pain differently. Whether you’re in pain right after childbirth or you develop a headache or breast issue weeks later, you don’t have to suffer just because you’re breastfeeding. There are safe pain-relieving options available to you. Talk to your doctor about choosing the best medication for the pain you are experiencing.

You might only need one dose of Motrin to get you through mild discomfort, or you may need a prescription to cope with a long-term issue. The important thing is to relieve your pain. When you’re in pain, it’s more difficult to breastfeed successfully and take care of your newborn. But with the right relief, you can feel well again—and get back to focusing on caring for your family.

Breastfeeding & Over-the-Counter Medications

Is it safe to take over-the-counter medicines while I am breastfeeding my baby?

The answer is usually “yes.” To provide some simple background information about this topic, briefly, here are some known facts about medicine and breast milk:

  • Nearly all medicines taken by a mother pass into human milk, BUT only in very small amounts–usually less than one percent of the dosage taken by the mother.
  • Because only a very small amount even passes into milk, there are very few drugs that SHOULDN’T be taken by a nursing mother.
  • IN MOST CASES, nursing mothers do not need to interrupt breastfeeding to take prescription or over-the-counter medicines. In the rare situation when you should not take a drug, you may try an alternative drug, a non-drug, or a procedure.

Two simple general rules that can help you determine if it is safe to take a medicine during breastfeeding are:

  • If a drug is commonly prescribed for infants, it is likely safe to take while nursing, since the baby would generally receive a lower dose from breast milk than from taking the drug directly.
  • Drugs considered safe to take during pregnancy are, with few exceptions, safe to take while nursing.

Are there any additional safety measures to consider while breastfeeding?

Even though most medicines are safe to take during breastfeeding, some additional safeguards to lower any potential risk even further include:

  • Only take a medicine if you REALLY need it. Consider alternative non-drug therapies, if possible.
  • Take the lowest possible dose for the shortest possible time.
  • Avoid extra-strength formulas. Also avoid “sustained-release”preparations and medicines taken only once or twice a day. These are considered “long acting” drugs and remain in the mother’s blood stream and milk supply much longer than drugs that need to be taken more frequently.
  • When possible, use single ingredient preparations rather than multi-symptom formulas. For example, if you only have a cough, use a single-ingredient cough suppressant rather than a cough suppressant combined with a decongestant.
  • Watch for signs of a possible drug reaction in your baby such as sleepiness, rashes, diarrhea, or colic. Although such reactions rarely occur, call your healthcare provider if you see such changes.
  • Finally, always read the medicine labeling and package insert for any precautions or warnings about taking the drug while breastfeeding. Never hesitate to call your doctor, the baby’s pediatrician, a lactation consultant, or your pharmacist if you have any concerns about taking a medicine while you are breastfeeding.

Which medicines are NOT safe to take while breastfeeding?

Some of the medicines that require temporary weaning are those that contain radioactive compounds and drugs used to treat cancer. Most of the drugs that raise any concern at all are prescription drugs, not over the-counter medicines.

For more information on unsafe medications that are geared to nursing mothers, please go to the United States National Library of Medicine, LactMed, which contains over 450 drug records. https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm

If I am a smoker, can I continue to smoke and breastfeed?

Of course, the best choice for your personal health and the health of your baby is to quit smoking. However, if you can’t quit, try to cut down. If you smoke less than a half a pack a day, the risks to the baby are small. Of course, the fewer cigarettes you smoke, the smaller the chance of encountering problems. Nicotine in large doses can cause low milk supply, a poor letdown reflex, and GI upset in some babies (for example, resulting in nausea/vomiting, abdominal cramps, and diarrhea). If you must smoke:

  • Don’t smoke around the baby, and smoke after you nurse.
  • Wash hands and face after smoking.
  • Cover your hair and change your clothes.
  • Do not smoke indoors.

Can I safely drink alcohol while breastfeeding?

Occasional or light drinking—such as a glass of wine or a beer—has not been found to be harmful to a breastfeeding baby. Erring on the conservative side, wait at least two hours for every drink you consume before nursing your baby. Or alternatively, use expressed milk to feed your baby after consuming alcohol.

Also, consider choosing drinks low in alcoholic content or that are diluted with water or juice.

Moderate-to-heavy alcohol consumption by a breastfeeding mother has been shown to interfere with the let-down reflex, inhibit milk intake, affect the baby’s motor skill development, slow weight gain, inhibit growth, and cause drowsiness in the baby.

Can I safely drink coffee while breastfeeding?

Drinking up to two 5-ounce cups of coffee per day does not appear to cause any problems for a mother and nursing baby. Drinking more than this amount can result in an irritable or fussy baby and a baby with poor sleeping habits. Some babies are sensitive to any amount of caffeine.

Remember to consider the amount of caffeine you drink from ALL of your beverages, including coffees, teas, colas, and even chocolate. Consider cutting back or switching to decaffeinated beverages.

Please consult your healthcare provider for advice.

90,000 Breastfeeding and drug administration

So the birth is behind, the birth pain has been forgotten, lactation has been established, and at any moment a new problem may arise for a young mother: how will the medicine affect the newborn baby when breastfeeding. Unfortunately, not every mother can boast of excellent health and there is a need to take medications.

The degree of adverse effect of the drug on the newborn’s body is determined by the following factors:

  1. toxicity of the drug;
  2. the true amount of medicine that has entered the child’s body;
  3. the peculiarity of the effect of the drug on the immature organs of the child;
  4. the duration of the removal of the drug from the child’s body;
  5. the duration of taking the medicine by a nursing mother;
  6. individual sensitivity of the child to this drug;
  7. the risk of developing allergic reactions.

Of the most commonly used drugs, most are not highly toxic drugs that cause significant toxic effects on organs and tissues. Therefore, it is believed that in many cases, with drug treatment, breastfeeding can be continued.

If a woman combines breastfeeding and treatment, it may be helpful to select the optimal scheme for alternating between taking the drug and feeding. It is necessary to take the medicine in such a way that the feeding time does not fall on the period of its maximum concentration in the blood.

When using the medicine, a woman during breastfeeding should know that the side effects caused by this drug may also occur in a child.

If the risk of adverse effects of the drug on the child’s body is high, then breastfeeding should be stopped for the duration of treatment, but milk should be continued to express to maintain lactation. After the end of the course of treatment, breastfeeding must be resumed. It is believed that after a course of antibiotics incompatible with breastfeeding, you can feed 24 hours after the last dose of the drug.And with the use of a number of radioactive agents, the radioactivity of milk can persist from 3 days to 2 weeks.

Features of the use of various groups of drugs during breastfeeding

Medicines contraindicated for breastfeeding:

Cytostatics and radioactive drugs (drugs used to treat tumors and autoimmune diseases, rheumatoid arthritis). These drugs significantly suppress immunity and cell division.If necessary, taking these drugs stop breastfeeding.

Antibiotics are used to treat various infectious and inflammatory diseases. Penicillins, cephalosporins, macrolides, aminoglycosides are usually not contraindicated for breastfeeding. These antibiotics penetrate into milk in small quantities, so their toxicity to the baby is low.

Macrolides (erythromycin, sumamed, vilprofen, etc.) penetrate well into milk, but their use during breastfeeding is possible.There is a potential risk of developing complications associated with the occurrence of allergic reactions, disruption of the normal intestinal flora (diarrhea), and the proliferation of fungi (candidiasis – thrush). For the prevention of dysbiosis, it is recommended to prescribe probiotics to the child (Bifidum Bacterin, Linex). If your baby has an allergic reaction, stop taking this antibiotic or temporarily stop breastfeeding.

Tetracyclines, sulfonamides (Bactrim, Biseptol, etc.), Metronidazole, Clindamycin, Lincomycin, Ciprofloxacin pass into milk, and the likelihood of developing negative reactions is high. Therefore, the use of these drugs while breastfeeding is contraindicated.

Side effects of tetracyclines are child growth retardation, impaired development of the child’s bone tissue and tooth enamel. Side effects of clindamycin are the risk of gastrointestinal bleeding; and Levomycetin – toxic damage to the bone marrow, the effect on the cardiovascular system.

Antihypertensive agents are used for hypertension.

When breastfeeding, the following medications can be used with caution: Dibazol, Dopegit, Verapamil.

Contraindicated for breastfeeding: Cordaflex, ACE inhibitors (Enap, Kapoten), Diazoxide, Reserpine.

The use of antihistamines for allergies during breastfeeding is possible. It is desirable to use Cetirizine, Loratadine.It is not advisable to use drugs of the 1st generation (Suprastin, Tavegil), which can cause drowsiness in a child. Use is contraindicated when breastfeeding Erius.

Antithyroid drugs for breastfeeding

Antithyroid drugs are used for diseases of the thyroid gland, which occur with an increase in its function. These medicines are used when breastfeeding with caution, while controlling the condition of the baby. They suppress the function of the child’s thyroid gland.

Salbutamol, terbutaline, fenoterol are approved for use in breastfeeding. It is necessary to monitor the condition of the child, since their side effect is excitement, increased heart rate.

Hormones (prednisolone, dexamethasone, hydrocortisone) are used for autoimmune diseases (rheumatoid arthritis, systemic connective tissue diseases, autoimmune hepatitis, etc., with adrenal insufficiency) are usually not contraindicated in breastfeeding.

However, if it is necessary to treat them for more than 10 days, the question of continuing breastfeeding is decided individually. If a woman needs long-term, high-dose hormonal treatment, breastfeeding should be discontinued.

Paracetamol is not contraindicated for breastfeeding if it is used in the usual dose (1 tablet up to 3-4 times a day, no more than 2-3 days). Exceeding the dose and prolonged use of paracetamol should be avoided, since a side effect of the drug is toxic effects on the liver and blood.

Contraceptives for breastfeeding

When breastfeeding, drugs containing progesterone are allowed. Other medications are contraindicated for breastfeeding.

Expectorants for breastfeeding
  • Ambroxol, Bromhexine, ACC can be used during breastfeeding.
  • Pre- and probiotics (Linex, Hilak forte, etc.) are compatible with breastfeeding.

It should be noted that in our Center for Mother and Child, all drugs used are safe for the health of the baby and mother.We try to minimize the prescription of medications; only in the most extreme case, medications are prescribed that are contraindicated for breastfeeding. And the most important recommendation is not to prescribe medications on your own, especially to nursing mothers! Health to you and your little ones!

Obstetrician gynecologist M. Nugmanova K .


Checked the manager. genus. house number 2 Markashova M. Yu.

Nursing medicines – drug search and availability in pharmacies

Through breast milk, the baby receives a large amount of vitamins and minerals necessary for his growth, physical and mental development.Breastfeeding helps build the baby’s immunity, protecting his body from infection. But what if mom got sick? Is it okay to take medications in this case? What medications can a nursing mother drink so as not to harm the health of the child?

Antiviral drugs

Approved antiviral drugs for lactating women:

  • Viferon
  • Grippferon
  • Inosine pranobex
  • Lamivudine
  • Laferobion

Homeopathic antivirals:

  • Anaferon
  • Aflubin
  • Oscillococcinum
  • Engystol

Antihistamines

Allergies can be manifested by a runny nose, redness of the eyes, and lacrimation.What allergy medications can a nursing mother need? In such cases, the doctor may prescribe the following antihistamines for nursing:

1. Derivatives of piperazine with minimal sedation:

  • Allertek
  • Letizen
  • Cetirizine
  • Cetrin

2. Drugs that practically do not penetrate into breast milk:

  • Claritin
  • Klarotadine
  • Loratadin
  • Loridin

3.Fexofenadine based preparations:

  • Allerfex
  • Dinox
  • Telfast
  • Feksadin
  • Fexofast

4. Funds based on levocytirizine:

  • Glenzet
  • Zenaro
  • Ksizal
  • Elset

Medicines for poisoning

What medications can a nursing mother take in case of poisoning? The treatment tactics will be as follows:

one.Sorbent intake:

  • Activated or white carbon
  • Smecta
  • Enterosgel
  • Polysorb

2. You can replenish the reserves of fluid and minerals with the help of Rehydron.

3. To restore bowel function, you can take:

  • Yoghurt
  • Linex
  • Any preparations containing bifidobacteria.

Thrush

Thrush is a frequent companion of women during the period of hormonal changes.Medicines against thrush for nursing mothers:

1. Tablets:

  • Fluconazole
  • Miconazole
  • Diflucan

2. Candles:

  • Geksikon
  • Gino-Pevaril
  • Neopenotran
  • Pimafucin
  • Terzhinan

Pain relievers

Pain Relief Medicines for Nursing:

one.Paracetamol:

  • Acetaminophen
  • Panadol
  • Efferalgan

2. Ibuprofen:

  • Nurofen
  • Ibuprom
  • Ibufen

3. Ketans:

  • Ketarolac
  • Ketalgin

4. Diclofenac:

  • Voltaren
  • Ortofen
  • Diklak

Preparations for the common cold

A runny nose is the main symptom of ARVI, the first sign of a cold.In this case, a nursing woman can use the following medicines:

1. Saline solutions for washing the nasal passages are absolutely safe for a woman and a child, perfectly moisturize the mucous membrane, help to free the nasal passages from mucus:

  • Aqualor
  • Aquamaris
  • Dolphin
  • Marimer
  • Rinolux
  • Saline
  • Physiomer
  • Humer

2.Oil-based drops soften, moisturize irritated mucous membranes:

  • Pinosol
  • Eucasept
  • Olive, eucalyptus, peach, pine oil

3. Vasoconstrictor drops relieve swelling, facilitate breathing. They must be used immediately after feeding. Breastfeeding women are allowed to use:

  • Indanazoline
  • Sanorin
  • Naphazoline

four.A runny nose caused by an allergy can be treated with the following remedies:

  • Sanorin-Anallergin
  • Rinatek
  • Nazaval

5. Homeopathic remedies:

  • Rinaldix
  • EDAS-131
  • Euphorbium

6. Local antibiotics can only be used as directed by a physician if other remedies do not help:

  • Isofra
  • Bioparox

Cough medicine

What cough medicines do doctors prescribe for nursing mothers? In such cases, predominantly safe drugs are prescribed, which are allowed for children:

  • Ambroxol in the form of syrup or tablets
  • ACC during lactation is permissible for admission, you only need to buy tablets without flavors and dyes
  • Gedelix
  • Dr. Mom
  • Coldrex Broncho (syrup) does not contain harmful additives and dyes
  • Licorice root
  • Lazolvan (tablets, syrup) promotes the discharge of phlegm from the respiratory tract
  • Mukaltin – natural-based tablets that effectively thin phlegm
  • Prospan syrup

Increased body temperature 90 105

At elevated nursing temperatures, it is allowed to take paracetamol and ibuprofen preparations according to the instructions.It is best to drink regular paracetamol and ibuprofen in pill form, as all kinds of syrups contain dyes and flavors that can cause allergies in the baby.

Medicine for sore throat lactating

The following medications can be used for sore throat:

1. Sprays and aerosols:

  • Ingalipt
  • Miramistin
  • Hexoral
  • Jocks

2. Lozenges:

  • Laripront
  • Lizobact
  • Sebidin
  • Septefril
  • Faringosept

3.Rinses:

  • Pharmacy chamomile
  • Furacilin – tablets for dissolution in water
  • Chlorhexidine

If a sore throat is a symptom of a sore throat, your doctor will prescribe an antibacterial drug. The advisability of suspending breastfeeding for the period of antibiotic treatment should be consulted with a specialist. During lactation appoint:

1. Macrolides:

  • Azithromycin
  • Sumamed
  • Roxithromycin

2.Penicillins:

  • Amoxicillin
  • Ampiox
  • Oxacillin

3. Cephalosporins:

  • Cefazolin
  • Cephalexin

Cystitis

Treatment of cystitis always involves taking antibacterial drugs:

  • Amoxiclav
  • Augumentin
  • Zinnat
  • Monural
  • Erythromycin

Phytopreparations:

  • Kanephron
  • Phytolysin

Hemorrhoids

What medicines for hemorrhoids can a nursing mother drink? Hemorrhoid treatment should be comprehensive.During lactation, the following drugs are allowed:

1. Laxatives:

  • Duphalac
  • Mucofalk
  • Forlax

2. Phlebotropic drugs:

  • Venoruton
  • Venza
  • Detralex

3. Candles:

  • Anusol
  • Posterizan
  • Natalsid

4. Ointment:

  • Posterizan
  • Proctosan
  • Emla

Sedatives

The following sedatives are allowed for a nursing woman:

  • Valerianahel
  • Nervohel
  • Novo-Passit
  • Persen
  • Motherwort
  • Valerian extract in drops or tablets
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90,000 Can you take medications while breastfeeding?

All breastfeeding mothers want to know if pills can be taken while breastfeeding.Will the medicine get into the milk, will it harm the baby, should the feeding be interrupted during the treatment? In search of answers to these questions, mothers often make mistakes: someone refuses therapy in favor of feeding, someone is forced by doctors to stop lactation in cases where it can be maintained. Mom.ru tried to figure out how to properly drink medicines while breastfeeding.

1

Ill, nursing mother should seek professional medical help – self-medication is unacceptable.The well-known pediatrician Yevgeny Komarovsky recommends immediately informing the doctor that you are breastfeeding – this way it will be easier for a specialist to prescribe medications for you and develop a scheme for taking them. When the drugs are prescribed, drink them right before the next feed to prevent the drug from entering the milk.

2

In most cases, when taking antibiotics (which can be prescribed, for example, for infectious mastitis), you do not need to interrupt breastfeeding, says Carl Weiner, a British gynecologist, author of the BabyCenter portal.According to him, only quinolones, broad-spectrum antibacterial drugs, can be considered unsafe.

3

One way or another, all medicines affect the body of both the mother and the child. For example, while taking antibiotics, you may notice that the child has become more moody. In addition, medication may change the color of your baby’s stool – this is normal and should not be interrupted because of this.

4

If the mother is prescribed medications that are not compatible with breastfeeding, the child must be transferred to the formula for the entire course of treatment.At the same time, as recommended by the World Health Organization, it is necessary to maintain milk production by expressing it manually or using a breast pump.

5

To check if a medicine prescribed by your doctor is compatible with feeding, you can go to the dedicated E-Lactancia website and enter the international drug name (in English) in the search form. The results will indicate what the risk is when taking a particular drug.

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90,000 what pills you can drink for pain


23.09.2019


Allowed

Forbidden

Paracetamol

Metamizole sodium (“Analgin”)

Ibuprofen

Nimesulid (“Nimesil”, “Nise”)

Drotaverin (“No-shpa”)

Acetylsalicylic acid (Citramon, Aspirin)

Ketorolac (Ketorol, Ketanov, Ketalgin)