Breastfeeding and Medications

 

Written by Samantha Sorden

As the number of Americans relying on prescription drugs continues to increase, breastfeeding moms need to be hyper vigilant about the prescription and over-the-counter medications they take. Almost all medications transfer into breast milk, but most are safe to take while breastfeeding because the amount of the substance that makes it into breast milk is relatively small, less than one percent of the dose.

If you’re ever in doubt, refer to this general rule: if a medication is safe to take during pregnancy, it is probably safe to take while breastfeeding. Acetaminophen and ibuprofen, commonly found in over-the-counter pain relievers, flu shots and hormonal contraceptive pills are among the medications considered safe for breastfeeding women. Physicians recommend you take a progestin-only contraceptive; research indicates that estrogen, commonly found in contraceptive pills, diminishes milk supply.

Generally, mothers can also drink alcohol while breastfeeding as long as alcohol intake is not excessive. Large amounts of alcohol in breast milk can trigger drowsiness, deep sleep, weakness and abnormal weight gain in infants; moms may also experience issues with their milk ejection reflex. Learn more about breastfeeding and drinking alcohol.

Although most prescription drugs are safe to take while breastfeeding, you should always consult with your physician before beginning a new medication or discontinuing use. A number of medications should be avoided while breastfeeding, including drugs prescribed to kill cancer cells, radioactive drugs and illicit drugs, according to the American Academy of Pediatrics’ Committee on Drugs.

Cancer-fighting drugs (cytotoxic drugs), including cyclophosphamide, methotrexate and doxorubicin, have toxic effects on cells and are commonly used in chemotherapy to kill cancer cells. These drugs may interfere with the metabolism and immune system of a nursing infant, so breastfeeding mothers should avoid these medications whenever possible. You should also steer clear of radioactive drugs, often used to treat thyroid cancer, as it may take weeks for the radioactivity to clear the breast milk.

The American Academy of Pediatrics’ Committee on Drugs urges mothers to avoid illegal drugs as well because they are hazardous to the nursing infant and to your health, not to mention they are illegal.

  • Amphetamines may cause irritability and poor sleeping patterns
  • Cocaine can cause irritability, vomiting, diarrhea, seizures and tremors 
  • Heroin can cause tremors, restlessness, vomiting and poor feeding. 
  • The National Institutes of Health advises mothers to abstain from marijuana use, although little research exists about the effects of marijuana on a nursing infant.

Obvious health effects, for both you and your baby, accompany the use of these drugs. But sometimes the negative impact on health isn’t always so apparent. Psychotropic drugs, including medication to treat anxiety, depression and psychosis, may alter short-term and long-term central nervous system function in breastfeeding infants. However, little research exists to back up this claim.

“Because of the long half-life of these compounds and some of their metabolites, nursing infants may have measurable amounts in their plasma and tissues, such as the brain,” according to the Committee on Drugs. “This is particularly important in infants during the first few months of life... Nursing mothers should be informed that if they take one of these drugs, the infant will be exposed to it. Because these drugs affect neurotransmitter function in the developing central nervous system, it may not be possible to predict long-term neurodevelopmental effects.”

Nursing moms can find a complete list of safe medications and medications to avoid on the American Academy of Pediatrics’ website.