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What are the risks of taking medication while breastfeeding?

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RisksMedications to avoidReducing risksWhat medications are safe?Summary
There are several risks to consider when taking medication while nursing, including the transfer of the medication to the infant through breastmilk and possible harm to their development. 
Medically reviewed by Monica Kean, PharmD
Written by Rashida Ruwa, RN
Updated on October 10, 2023

Breastfeeding or chestfeeding is a natural and recommended way to nourish your baby, providing essential nutrients and building a strong bond between parent and child. 

However, while many medications are considered safe during breastfeeding or chestfeeding, others can transfer to breast milk and harm your baby’s health and development.

What are the risks of taking medication while breastfeeding?

Female nursing a baby to depict how some medications are not safe while breastfeeding.
1389340934Antonio Hugo Photo/Getty Images

There are several possible risks to consider when taking medication while nursing. This includes:

Transfer of medications through breastmilk

When you take medications while breastfeeding or chestfeeding, they can pass into your breast milk and be consumed by your nursing infant. This means that any potential side effects or risks associated with the medication may also affect your baby.

Consider discussing the risks and benefits of prescription medication use during nursing with a healthcare professional. 

Potential harm to infant’s development

Certain medications can adversely affect a nursing infant’s developing nervous system. This is particularly concerning during critical periods of development, especially in the early stages of life.

A 2018 study found certain medications pose a risk to the developing nervous system of nursing infants.

Another 2023 study found that some medications can disturb the balance of the infant’s gut microbiome. This disruption may have long-term implications on immune function and overall well-being.

However, these risks may vary depending on the specific medication, dosage, and individual factors. To ensure your baby’s safety, consider talking with a healthcare professional before taking any medications while breastfeeding or chestfeeding. 

What medications should be avoided while breastfeeding?

While many medications are considered safe during breastfeeding or chestfeeding, some should be avoided due to potential risks to the nursing infant. These medications include:

  • Codeine (Tylenol with Codeine): Codeine is an opioid medication used to treat pain. However, it can be especially dangerous when taken by someone who is nursing, as it can cause respiratory depression and even death in nursing infants.
  • Diazepam (Valium): Diazepam is a benzodiazepine used to treat anxiety, muscle spasms, and seizures. It can accumulate in an infant’s system, leading to drowsiness and poor feeding.
  • Lithium (Eskalith): Lithium is a medication used to treat bipolar disorder. However, it can transfer to breast milk and cause toxicity in nursing infants, leading to poor weight gain, lethargy, and even cardiac arrhythmias.
  • Ergotamine (Ergomar): This medication treats migraine, but it passes through breast milk and can cause vomiting, diarrhea, seizures, and other symptoms in nursing infants. 
  • Methotrexate (Trexall): Doctors prescribe this medication to treat certain types of cancer and autoimmune diseases. However, it passes through breast milk and can cause severe side effects, including anemia, immune suppression, and infant developmental delays.
  • Pseudoephedrine (Sudafed): A decongestant used to relieve nasal congestion, Pseudoephedrine can reduce milk supply and cause irritability and sleep disturbances in nursing infants.

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How can these risks be minimized? 

There are several strategies that may help to minimize the risk of taking medication while breastfeeding or chestfeeding. Options to consider include:

  • Consult a healthcare professional: The most crucial step is to consider talking with a doctor before taking any medication while breastfeeding. They can assess your situation, weigh the potential risks and benefits, and recommend the most suitable treatment options.
  • Consider alternative medications: There is often a safer alternative drug for people who are nursing and their infants. For example, acetaminophen (Tylenol) is often recommended over ibuprofen (Advil) for pain relief during breastfeeding or chestfeeding.
  • Timing: Taking medications immediately after breastfeeding can help minimize the concentration of the drug in breast milk during the next feeding. This can reduce the infant’s exposure to the medication.
  • Short-term use: Where possible, opt for medications that are needed for a short time and at the lowest effective dose. Short-term use can reduce the overall exposure of the infant to the medication.
  • Express and store milk: If a healthcare professional advises, you can express breast milk and store it before taking certain medications. This can allow you to maintain your milk supply while minimizing your child’s exposure to the medication.
  • Monitor the infant: Keep a close eye on your baby for any unusual signs or symptoms while taking medication. If you notice any changes in your baby’s behavior or health, consult a healthcare professional immediately.
  • Drug “pump-and-dump”: A healthcare professional may sometimes recommend “pump-and-dump” sessions, where you pump and discard breast milk for a specified period after taking medication. This helps remove any traces of the drug from your breast milk.

What medications are considered safe to take while breastfeeding?

Many medications are considered safe for breastfeeding or chestfeeding when used appropriately. However, it is important to talk with a healthcare professional before starting any medication while nursing. 

Medications that are considered safe include:

  • Acetaminophen (Tylenol): Acetaminophen (Tylenol) is commonly used to relieve pain and reduce fever. It is considered safe when used as directed during nursing.
  • Cephalosporins: Cephalosporin antibiotics such as cefdinir (Omnicef) are considered safe. They are commonly used to treat various bacterial infections.
  • Levothyroxine (Synthroid): Levothyroxine (Synthroid) is a medication to treat thyroid disorders and is generally safe for those who are nursing.
  • Loratadine (Claritin): Loratadine (Claritin) is an antihistamine that relieves allergy symptoms and is generally safe for those who are breastfeeding or chestfeeding.

Summary

The decision to take medication while nursing is a critical one that should be made with careful consideration and guidance from healthcare professionals. 

Some medications can pose potential risks to the nursing infant. However, with guidance from healthcare professionals, it is possible to find safer options or adjust your medication use to minimize the risk.

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