Everyday life doesn’t pause because you’re pregnant or nursing. You will continue to get occasional headaches, your back may grow sore from time to time, and you will still need to appropriately manage chronic conditions. Therefore, it’s likely you will need to take medications while breastfeeding at some point during your child’s early years.
Many new moms are hesitant to start or continue taking medications while they’re nursing. They fear that residual effects of any medicine taken could have unintended consequences for their child.
Dispelling these concerns is best accomplished by having a discussion with your OBGYN or midwife. You’ll be able to discuss which medications while breastfeeding may be safe and which may carry heightened risks.
Can I Take Medications While Breastfeeding?
More than 80% of mothers breastfeed their newborns. The unique properties of breastmilk make it a singularly optimal vehicle for nutrition, the physical and cognitive benefits of which have been well researched and documented. Not every mother can or chooses to breastfeed, but those who do find the experience enriching and satisfying.
Drug manufacturers are generally not required to investigate the impacts of their pharmaceuticals on nursing mothers. Generally, the best available evidence suggests that most medications are safe to take while you are breastfeeding. But there are some important caveats to be aware of, and you should always check with your doctor, OBGYN, or midwife about any medications you might consider taking while you are nursing.
Prescription vs. Over-the-Counter
When most people talk about “medications,” they’re usually referencing one of two categories of pharmaceuticals: prescription or over-the-counter. A prescription medication requires the approval of a physician to obtain, whereas an over-the-counter treatment can be purchased by a consumer with no medical input. In general, prescription medications will be more powerful; over-the-counter options will be less potent but likely produce side effects in a smaller portion of the population, but you never want to assume a medication is okay without checking first.
The vast majority of over-the-counter medications are relatively safe for you to take while nursing, but there is still some variation. Ibuprofen and Tylenol are typically considered safe for nursing mothers who want to manage common pains and discomfort.
When you discuss the possibility of taking medication while breastfeeding with your OBGYN, you should also take time to discuss any common over-the-counter drugs you may take, however infrequently that might occur.
Because prescription medications require a physician’s authorization to fill, your doctor or OBGYN will be able to answer questions you might have about any possible risks to your infant. Prescribers from other offices need to be made aware of your breastfeeding status, too.
Some Medications to Avoid When Nursing
There are several prescription medications that are known to cause adverse reactions in breastfeeding infants. Most doctors and OBGYNs will recommend that these medications should be avoided by nursing mothers. Some of those medication groups include:
- Opioid-based pain relievers (this could include but is not limited to Oxycodone or Tramadol, for example)
- Anti-cancer medications
- Retinoid-based medications
- Chloramphenicol (a specific type of antibiotic)
This list is not exhaustive. Parents that have any doubts about whether their breast milk is safe due to a medication they are taking should clarify with a professional. If your OBGYN recommends that you avoid taking a medication or temporarily switch to formula, it is critical you follow that advice.
Is My Child Drinking My Medications?
For most parents, the root of this topic is a very straightforward concern: is my infant drinking the medications I’m taking? Parents are understandably worried that any medication they might ingest will find its way into their breastmilk and adversely affect their child.
In most cases, medication does make its way into the breastmilk but in such small quantities as to be effectively harmless for most infants. That said, there are some medications that concentrate in the breast milk; medical professionals will be well versed in those medications, so a conversation with your OBGYN should ensure you’re able to steer clear of them.
Weighing the Risks
In many cases, the decision to take a medication will come down to weighing the risks involved–not only to the infant, but to the parents as well. For example, most antidepressants carry minimal risks in terms of breastfeeding infants. But the risks to a parent who abruptly stops taking some types of antidepressants could be significant. In those cases, your doctor will likely recommend that you continue taking your prescribed medication.
How to Minimize Risks to Your Child
There are also some ways that you can minimize the risks to your child. For example, if you take medications immediately after expressing milk or breastfeeding, you may limit the possible exposure to your baby. But the success of that strategy will depend on the medication you’re taking, so it’s always a good idea to double check with your doctor or OBGYN.
There are also some situations in which the risks to your infant may be particularly high, regardless of the medication or other steps you may take:
- If your infant was born prematurely, they may be more susceptible to small amounts of medication that present in your breast milk.
- Likewise, if your infant is underweight, less medication may have a greater proportional impact.
- If your infant has other underlying health conditions, you’ll also want to be especially careful about medication choices you make.
- Typically, the risks of an adverse reaction to medication through breastfeeding are most pronounced through your baby’s first six months.
Watch for Reactions
If you’re concerned about your infant having a reaction to medication ingested via breastmilk, keep a close eye for the following:
- Changes in sleeping habits (either sleeping more or less than usual)
- Changes in eating habits (likewise, eating more often or less often than usual)
- The development of an unexplained rash
- Sudden changes in your baby’s behavior
- Unexplained fussiness
If you notice any of these symptoms, you should contact a medical professional.
How Can I Check on Medications
There are over 3700 unique pharmaceuticals on the market today, and of those, less than 500 have been tested and observed in nursing mothers. A database of available results can be found at LactMed, a website managed by the National Institutes of Health.
This resource is generally not intended for non-medical individuals to make self-directed medication choices, but rather to facilitate conversations between OBGYNs and patients about the safety of a particular medication.
Make Time to Talk About Medications
Whether prescription or over-the-counter, taking medications while breastfeeding can be complicated. That’s why it’s essential that you create some time to talk about medications you’re likely to take with your OBGYN, who will be able to answer your questions about possible interactions.
In general, the majority of medications will be safe for you to take while nursing. But there are some major categories of drugs that you’ll want to consider carefully. And every parent has unique needs to balance when making decisions about medicating.
The best place to get individualized answers, then, will be from your OBGYN. Be frank about your medical history, current or future prescription drug use, and over the counter medications that might be in your cupboard. Guided by your OBGYN, you’ll be able to make smart, safe choices about which medications to take while nursing and which to avoid.