Not all too long ago breastfeeding mums were strongly discouraged from taking any medications while feeding their babies – or they were even advised to stop breastfeeding entirely. Recent research, however, has revealed that many common medications prescribed to breastfeeding mums may enter the milk in negligible amounts, or a drug may not have an effect on the milk at all.
With that said, not all medications are safe to use while breastfeeding, and some require more caution than others. First, we’ll talk about why many medications appear in trace amounts in breast milk, and then explore which medications may be safe to take along with some helpful suggestions.
Why many medications appear only in small amounts
A lot of the most common medications prescribed today are found only in small amounts in a mother’s breast milk for a couple of reasons. One reason is that only drugs not attached to the protein in a mother’s blood will be found in her breast milk.
Another reason is that the amount of a drug found in a mother’s milk depends on the concentration of that medication in the mother’s blood, and even then breast milk will usually have a much smaller amount of that drug. For example, a study on the drug Paxil (paroxetine) found that even though a breastfeeding mother took over 300 micrograms per kilogram of the drug each day, the baby only received about 1 microgram per kilogram per day.
When medications may be safe to take
If at any point you are prescribed a medication by your healthcare professional, it’s critical that you let your doctor know that you are breastfeeding. This is important not only to protect the health of your baby but also because some medications can have an adverse effect on milk production.
Medications are generally safe for breastfeeding mums to take if:
- The medication can be prescribed for infants
- The medication is considered safe during pregnancy (though this is not always true, such as when it comes to SSRI-type antidepressants)
- The medication is not absorbed from the stomach or the intestines
- The medication is too large to be excreted into the milk (this is the case with insulin, heparin, interferon, etanercept [Enbrel] and infliximab [Remicade])
Medications usually considered safe while breastfeeding
A lot of today’s most common medications are considered safe when taken as prescribed, such as acetaminophen (Tempra and Tylenol) and alcohol. As of the writing of this post, other safe medications include:
- Non-steroidal anti-inflammatory medications (ibuprofen)
- Tricyclic anti-depressants and most other anti-depressants including sertraline (Zoloft) and paroxetine (Paxil)
- Propylthiouracil (PTU)
- Omeprazole (Losec)
- Metronidazole (Flagyl)
Most antiepileptic and antihypertensive medications are also considered safe while breastfeeding.
When taking medication, watch your baby for any drug-related side effects like sleepiness, poor feeding, irritability, or anything else which may be a cause for concern.
Tips for using medications while breastfeeding
If you are concerned about the amount of medication you may be transferring to your breast milk, you can try an alternative medication as prescribed by your doctor. Some other options to consider include:
- Using the lowest dose possible to manage your symptoms
- Take medications immediately after feeding your bubs or before their longest sleep period
- Consider using an alternative application method (e.g., using a nasal spray instead of a tablet to clear up a stuffy nose)
- Express and discard milk if you’re only taking a medication for a few days
Always get the advice of an expert medical professional
Keep in mind that the information provided above should only be used as a guideline and that it does not replace the recommendation of your doctor. Weighing the benefits of breastfeeding and taking both prescribed and over the counter medications is something best assessed and addressed with your family doctor.