What Medications Are Safe to Take While Breastfeeding

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Drugs Found In Breast Milk.

You might be concerned about certain drugs being transferred into your breast milk and their effects on your baby. Some ladies decide not to breastfeed at all, due to strong medication given in the case of epilepsy or hyperthyroidism. 

Many Mothers believe that it is better for their babies to drink formula and avoid the risk of these drugs entering into their breast milk but there are very few medications that are contraindicated during breastfeeding, and it is advised to first check with the American Academy of Paediatrics before deciding to wean

In the first week of a baby’s life, while the mother is still producing colostrum, it is important to remember that drug transfer into the breast milk is much easier during this time and that the baby should be monitored closely. 

There are several factors which influence whether a particular drug will enter the breast milk more than another, if at all.

Risk Factors Include

  • Plasma concentration: Some drugs have a higher level of build up in the mother’s blood, and these are more likely to be transferred into the breast milk. 
  • Molecule size: Drugs that have bigger molecules are less likely to pass through cell membranes and into the breast milk. 
  • Binding of proteins: Drugs that attach to proteins in the mother’s blood are less likely to pass into the breast milk. 
  • Fat solubility: Drugs that can dissolve in fat are more likely to pass into the breast milk and can be carried along with the fat in breast milk. 
  • Bioavailability: Drugs that are not taken orally by the mother (taken via injection, inhalation or cream), can sometimes have no effect on the baby when consumed orally via the breast milk. 
  • The half-life of the drug:  The time it takes for half the amount of this specific drug to leave the bloodstream. Some drugs are used up quickly and then passed out in the urine and feces. 

Individual Risk Factors of Drug Safety

  • There is low risk for babies who are older than six months old. Babies who are older can get rid of toxins in their systems easier than younger ones, and older babies also do not depend as much on breast milk for their entire nutritional requirements. 
  • There is a medium risk for those babies who are younger than six months and who have specific problems with their metabolisms or their guts. 
  • There is a very high risk for those babies who are premature or sick, especially those with impaired kidney function. 

How to Minimize Drug Effects

How long to wait to nurse after taking medicine?

  • If a medication has a short half-life, the mother can avoid feeding her baby until the drug levels have lowered.
  • Mom can pump and dump milk during the times that she is taking risky medication, this is just to keep her milk supply up.
  • Choose medications that are less risky, ask about alternatives. Ask about pediatric approved medications. 
  • Ask about medications that have higher protein binding and those that are of larger molecular size. Also, ask about medicines that do not pass easily into the blood-brain barrier, if possible.
  • Always keep an eye on the baby. Watch especially for drowsiness and gut issues. 
  • Take the medication straight after you have breastfed your baby; this will give the meds a long time to leave your system before you breastfeed again.
  • Avoid taking any unnecessary medication.

Drug package inserts cannot be used to determine whether a drug is safe or not. Drug companies do not do studies that involve pregnant and breastfeeding women, and always add a “not to be taken while pregnant or breastfeeding" on the package, just to protect themselves against lawsuits.

Using CBD oil while breastfeeding

Medications that should be Avoided 
(not a complete list)

Some medication may decrease milk supply (especially meds containing pseudoephedrine, flu medication, and contraceptives)

List of drugs contraindicated in breastfeeding:

1. Radioactive substances (The mother will need to pump and dump while on these if she wishes to continue to breastfeed afterward)

2. Anticancer drugs (antimetabolites).

3. Immunosuppressive and Antineoplastic drugs.

4. Amphetamines.

Some drugs that are known to Decrease milk production:

  • Alcohol.
  • Estrogens (often found in birth control pills).
  • Ergot Alkaloids (Bromocriptine & Cabergoline).
  • Progestogens.
  • Pseudoephedrine. 

Medications that is possibly harmful to a baby while breastfeeding

  • Lithium.

Safe Drugs While Breastfeeding

Some drugs that are known to Increase milk production:

  • Motilium (Domperidone) This drug is often prescribed to increase milk production. Reglan (Metoclopramide).
  • Risperidone.
  • Phenothiazine Neuroleptics.

A list of some safe medication while breastfeeding

  • Acetaminophen / paracetamol (Tylenol and Panadol)
  • Ibuprofen (Advil, Nuprin, Motrin)
  • Dextromethorphan (the active ingredient in Triaminic, Robitussin, Coricidin.)

A list of medication that is still safe, but not as safe as the above "safe" medication

  • Selective serotonin reuptake inhibitors (SSRIs) such as Sertraline (Zoloft) and Paroxetine (Paxil).
  • Bupivacaine (Marcaine).
  • Fentanyl. Aside from being a hundred times more potent than morphine, Fentanyl is highly addictive, and breastfeeding moms should avoid it if they can.

A list of medication that is only moderately safe while breastfeeding

  • Aspirin.
  • Codeine.

Is taking Pepto Bismol safe while breastfeeding?

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Cold Medicine While Breastfeeding
(Decongestants and More) 

Concerned about which decongestants are safe while breastfeeding?

All medicine while breastfeeding that is taken, should be taken immediately after a breastfeeding session, so that it has time to leave your system before breastfeeding again. Always check with your doctor before taking any decongestants while breastfeeding.

The Best Decongestant Medicine While Breastfeeding

Best remedies:

  • Saline nasal spray.
  • Neti pot rinse.
  • A cotton ball with eucalyptus oil put under your nose can open the nasal passages. 
  • Using a humidifier with about 15 drops of essential oils such as balsam or eucalyptus. 
  • Eating Cayenne pepper in your food, will dilate the blood vessels and help with mucous drainage. 
  • Fenugreek tea is a natural decongestant and will help increase milk supply.

Warning on medication and breastfeeding:

As with any medicine, while breastfeeding, it is always best to keep an eye on your baby for signs of drowsiness, fussiness, allergic reactions or any change in eating habits. 

Other safe decongestant while breastfeeding:

  • Antihistamines and breastfeeding: Allegra, Claritin, Seldane, and Actidil are safe to be taken by breastfeeding mothers and has no effect on lactation. Benadryl is safe in moderation, but a mother should check her baby for signs of drowsiness when taking any antihistamines while breastfeeding. 
  • Multi-symptom medication treats more than just congestion and should be avoided, as they contain more than one active ingredient.  
  • Breastfeeding safe medicines nasal decongestant: Over-the-counter nasal decongestants that contain either Oxymetazoline or Phenylephrine.  These are actually preferred over oral medications and are found in minuscule amounts in the breast milk, due to minimal absorption. 

What Pain Medication Is Safe While Breastfeeding

Motrin and Advil are regarded as safe for breastfeeding mothers to consume, but Ibuprofen is the highest recommended medication to choose for pain relief while breastfeeding.

Other Specific Medications

Can you take Advil while breastfeeding?

Short-term use at doses prescribed by a "breastfeeding friendly" doctor is fine. 

Can you take Mucinex while breastfeeding?

Mucinex is the trade name for Guaifenesin. This medication helps to loosen mucus. This medication is safe to take while breastfeeding. 

Can you take Dayquil while breastfeeding?

Dayquil is considered safe while breastfeeding; it contains Dextromethorphan, which is also found in Tylenol, and NyQuil. 

Can you take Sudafed while breastfeeding?

Sudafed is the trade name for pseudoephedrine. It is a decongestant. This medication is safe to take while nursing, but it can reduce milk supply. It has also been reported for irritability in some babies. So, keep an eye on your milk supply and any behavioral differences in your baby. 

Can you take Benadryl while breastfeeding?

Benadryl may decrease your flow (let-down) of milk. It is easily passed through the breast milk. Benadryl has been known to cause drowsiness, excitability, and irritability in infants whose mothers take this drug. Newborns are especially sensitive to this drug. 

Natural Alternative Medicine for Colds

  • Vapor rub, eucalyptus oil.
  • Saline nasal sprays.
  • Gargle with salt water.
  • Take a multivitamin and extra vitamin C.
  • Rest. Eat and drink well.
  • Olive Leaf extract will boost the immune system.
  • Use a humidifier.
  • Echinacea is great for boosting your immune system and is safe for breastfeeding mothers.
  • Garlic is a natural antibiotic.
  • Cayenne pepper and nutmeg can help for prevention and treatment of colds. Use on all foods.
  • Fenugreek tea can help for head and chest congestion and even for a cough. Fenugreek also increases milk supply.
  • Slippery elm bark comes in throat lozenges.

Signs That Your Baby Does Not Agree with a Particular Medication

  • Baby is more unsettled and fussy than usual.
  • Baby has diarrhea.
  • Baby is not sleeping enough.
  • Your milk supply is starting to dry up.

Always ask your doctor before taking any medications while breastfeeding.

Pumping and Dumping After Surgery

by Amberdove (Wyoming )

"Hi, my son will be about 12 weeks when I need to have a simple surgery, but I do have to be knocked out, so my Dr says to pump enough for 24 hours. Then I will need to pump and dump milk during that 24 hours. How do I know how much to pump? He is gaining 2 - 2 1/2 oz per day and going through a spurt right now so I will need to wait a week. Then I only have 3 weeks...if I pump only once per day, is that enough?"

Re: Some Medications are Safe

by Lyssa

"For the most part, doctors do not know the effect of medications on lactation.There just haven't been enough studies, or doctors do not find the need to stay up to date on the information.The Infant Risk Center is a fantastic resource of the most up to date information on what medicines are safe to use and what medicines you need to wait to clear your system and how long that takes.Most doctors play it safe and just say 24-48 hours without even knowing. I strongly suggest you obtain the list of medication you will be given and call the center(you can do a simple google search for their number).Usually, it is recommended that the mom is okay to breastfeed upon waking up from general anesthesia. By the time you wake up, the medicine has left the system enough to make it safe to breastfeed. If this is your only concern, then no need to worry about pumping and dumping.But to answer your question, a baby usually eats 1-1.5 oz for every hour between feeds. So that could mean leaving your baby 24-30 oz of pumped milk. If you are unable to pump, you could consider obtaining donated milk from another mom."

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