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Breastfeeding and your medications.  Is your baby safe?

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Breastfeeding and your medications. Is your baby safe?

As a Family Medicine Physician I have been asked countless times by new mothers what medications are safe for them to take while breastfeeding. This is always a tricky question because quite frankly the answer is often, “it depends”. Specifically, it depends on the age of the infant, as premature infants absorb medications at a different rate than those born at full-term. It also depends on the concentration level of the drug in the breast milk, the amount of breast milk consumed by the infant, and the overall health of your infant. That being said, the American Academy of Pediatrics has stated that most medications are safe and compatible with breastfeeding. For those that aren’t safe there is often an alternative.

To be clear, medications will transfer into human milk to some degree, although it is very often in low quantities and rarely enough to produce clinically significant doses in the nursing infant. But most moms don't want to take even a small risk of harming their precious little ones so here is a bit more information that I hope you find helpful.

First, I must foot stomp that it is important for nursing mothers to inform their child’s pediatrician about all of the medications they are taking, to include supplements, to assure safety. This gives your child’s doctor an opportunity to review with you the safety of your child with regards to your medications. Although not inclusive, I’ve included a list below of medications for common medical conditions that have been traditionally classified as safe to take while nursing. Please use this merely as a reference and verify with your Pediatrician or Family Medicine doctor for your child, your specific medical condition, and your nursing frequency.

Medical Condition

Compatible Medication (Generally considered safe to take)

Seasonal Allergies

Pseudoephedrine (Sudafed-may cause decreased milk production), Nasal steroids such as Beclomethasone (Beconase) and Fluticasone inhaled (Flonase), Cromolyn (Nasalcrom)

Asthma

Fluticasone (Flovent), Cromolyn (Intal), Nedocromil (Tilade)

Hypertension

Hydrochlorothiazide, Metoprolol, Propanolol, Labetalol

Diabetes

Insulin, Glyburide (Micronase)

Pain

Ibuprofen (Motrin), acetaminophen (Tylenol)

Migraine

Sumatriptan (Imitrex)

Depression/Anxiety

Sertraline (Zoloft), Paroxetine (Paxil), Lorazepam (Ativan)

Thyroid disorder

Levothyroxine (Synthroid), propylthiouracil (with monitoring for liver damage)

Infection

Most antibiotics whose name ends in “cillin” (ie. Amoxicillin, ampicillin)

Contraception

Progestin-only contraceptives like levonorgestrel, Mirena IUD, norethindrone (mini-pill) medroxyprogesterone acetate (depot provera); Copper IUD

 

To further decrease risk to your child additional tips are listed below.

Minimizing the risk to your child from medications

Avoid medications if possible to do so without causing you harm

Use topical medications when possible

For once daily medication; take just after your child’s bedtime

For medication take more than once daily; nurse your child immediately before your medication dose

 

There are great resources available should you desire further information or your medication is not listed above.  Below I’ve listed a couple credible references for you to find more specific information.

Dr. Hale's Breastfeeding Pharmacology Website (Thomas W. Hale, RPH, PhD)

LactMed Database is a free electronic database regulated by the National Library of Medicine

 photo credit


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