Breastfeeding and Medications: What Nursing Moms Must Know

Breastfeeding is like nature’s own magical bond between a mother and her baby. Providing countless benefits for both mom and baby.

But when you’re feeling unwell or need treatment for a condition, one major question arises:

“Is this medication safe while breastfeeding?”

It’s a valid concern – some medications pass into breast milk, while others don’t.

The good news? Many medications are breastfeeding-safe, and with the right precautions, you can continue nursing while taking care of your health.

This guide will help you understand how medications affect breast milk, which medications are safe or not, how to minimize risks when taking medication, and what to do if your medication isn’t breastfeeding-friendly.

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How Medications Affect Breast Milk

When you take medication, some of it may pass into your breast milk. The amount that transfers depends on:

• Type of medication – Some drugs pass into breast milk in small amounts, while others transfer more.
• Dosage – Higher doses increase the amount reaching your baby.
• Timing – Medications peak at different times in your bloodstream. Taking them after nursing can help reduce exposure.
• Your baby’s age – Newborns and premature babies are more sensitive to medications than older infants.

If you’re breastfeeding and need medication, talk to your doctor to ensure it’s safe for you and your baby.

What Medications Are Safe While Breastfeeding?

Many common medications are considered safe for breastfeeding mothers. The following list is based on recommendations from the Mayo Clinic and Cleveland Clinic.

Pain Relievers

• Acetaminophen (Tylenol, Paracetamol) – Commonly used for pain and fever; considered safe while breastfeeding.
• Ibuprofen (Advil, Motrin) – Anti-inflammatory and pain relief; safe in standard doses.
• Naproxen (Aleve) – Generally safe for short-term use, but prolonged use should be monitored.

Antibiotics

• Amoxicillin – Commonly prescribed and safe for breastfeeding.
• Cephalexin (Keflex) – Safe for treating bacterial infections.
• Azithromycin (Zithromax) – Often used for respiratory infections; considered safe.
• Clindamycin – Safe but may cause mild digestive discomfort in some infants.

Allergy & Cold Medications

• Loratadine (Claritin) – Non-drowsy antihistamine, safe while breastfeeding.
• Cetirizine (Zyrtec) – Another non-drowsy antihistamine, safe for nursing moms.
• Fexofenadine (Allegra) – Considered safe for treating allergies.
• Diphenhydramine (Benadryl) – Safe, but may cause drowsiness in both mom and baby.

Decongestants & Cough Medicines

• Guaifenesin (Mucinex, Robitussin) – Expectorant, safe for breastfeeding moms.
• Dextromethorphan (Delsym, Robitussin DM) – Cough suppressant, generally safe.
• Saline nasal spray – Best natural option for congestion relief.

Gastrointestinal Medications

• Docusate sodium (Colace, Dulcolax Stool Softener) – Safe for treating constipation.
• Psyllium fiber (Metamucil, FiberCon) – Safe for relieving constipation.
• Loperamide (Imodium) – Used for diarrhea, considered safe for short-term use.
• Famotidine (Pepcid AC) – Safe alternative for acid reflux treatment.

Antidepressants & Anti-Anxiety Medications

• Sertraline (Zoloft) – Commonly prescribed for postpartum depression; considered safe.
• Paroxetine (Paxil, Brisdelle) – Often recommended as a first-line treatment for anxiety or depression.
• Fluoxetine (Prozac, Luvox) – Can be used but may require monitoring for mild effects on the baby.
• Escitalopram (Lexapro) – Considered safe for treating anxiety and depression.

Birth Control

• Progestin-only pills (Minipill) – Does not affect milk supply.
• Hormonal IUDs (Mirena, Kyleena, Skyla) – Safe and effective long-term contraception.
• Copper IUD (Paragard) – Hormone-free and safe for breastfeeding.

Vitamins & Supplements

• Prenatal vitamins – Recommended for breastfeeding moms to support nutrition.
• Vitamin D supplements – Often recommended for both mom and baby.
• Calcium and magnesium – Safe and beneficial for maintaining bone health.

Safety Precautions

While many medications can be safe to use, you should take precautions to minimize potential risks:

• Avoid unnecessary medications: Whenever possible, opt for non-pharmacological treatments or alternative meds that are safer for breastfeeding.
• Monitor your baby: Pay attention to any changes in your baby’s behavior or health while taking meds. If you notice any concerning symptoms, contact your doctor immediately.
• Stay informed: Keep yourself updated when it comes to meds and breastfeeding. Consult with reliable sources like lactation consultants, reliable websites, and of course, keep that line of communication open with your doctor.

What Medications Should Be Avoided While Breastfeeding?

While many medications are safe for nursing moms, some can be harmful to your baby because they pass into breast milk at high levels or have serious side effects.

The following list is based on CDC and LactMed guidelines.

Strong Pain Medications (Opioids)

• Codeine – can cause excessive sleepiness, breathing issues, or life-threatening respiratory depression in infants.
• Oxycodone (OxyContin, Percocet) – can cause high risk of sedation and respiratory depression.
• Hydrocodone (Vicodin, Norco) – similar risks as oxycodone, including drowsiness and breathing difficulties.
• Tramadol – can cause dangerous drowsiness and breathing problems in newborns.

Safer alternatives: Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin).

Medications for Mental Health & Neurological Conditions

• Lithium – can cause toxicity in infants, leading to dehydration, vomiting, and heart issues.
• Clozapine (Clozaril) – can increase the risk of seizures, sedation, and low white blood cell counts in infants.
• Phenobarbital & Primidone – can cause severe sedation, poor weight gain, and developmental issues in infants.

Safer alternatives: Sertraline (Zoloft) or fluoxetine (Prozac), but always consult your doctor.

Medications for Migraines & Headaches

• Ergotamine (Cafergot, Migergot) – can cause vomiting, diarrhea, and increased blood pressure in infants.
• Dihydroergotamine (DHE 45, Migranal) – similar risks as ergotamine, including nausea and circulation issues.

Safer alternatives: Acetaminophen, ibuprofen, or sumatriptan (Imitrex) with doctor approval.

Decongestants & Cold Medications

• Pseudoephedrine (Sudafed) – can significantly reduce milk supply.
• Phenylephrine – minimal data, but may impact milk production.

Safer alternatives: Steam inhalation, saline nasal spray, and honey for cold relief.

Hormonal Medications

• Estrogen-containing birth control pills – can lower milk supply and reduce breastfeeding duration.
• Testosterone or anabolic steroids – can affect the baby’s development and hormone balance.

Safer alternatives: Progestin-only birth control (minipill, IUD, implant, or Depo-Provera shot).

Medications for Infections

• Tetracycline antibiotics (Doxycycline, Minocycline) – can stain baby’s developing teeth if used long-term.
• Chloramphenicol – can cause a life-threatening condition called “gray baby syndrome.”

Safer alternatives: Amoxicillin, cephalexin, and azithromycin.

Herbal Supplements & Alternative Medicines

• High doses of Vitamin A & E – can accumulate in breast milk and become toxic.
• Ginseng & Ginkgo Biloba – can cause irritability and digestive issues in babies.
• Kava & Kratom – may cause drowsiness and liver toxicity.

Always consult your doctor before taking any herbal supplements while breastfeeding.

What If Your Medication Isn’t Safe for Breastfeeding?

Now, let’s say you find out that the meds you need aren’t exactly breastfeeding-friendly.

It happens, and it’s totally okay. Your health matters just as much as your baby’s, right?

So, if you need to hit pause on the breastfeeding journey for a bit while you sort out your medication situation, don’t sweat it.

Your healthcare provider can help you come up with a game plan. They might suggest pumping and storing milk before starting your meds, so your little one can still get all the goodness of breast milk while you’re taking care of yourself.

And hey, if formula ends up being the way to go for a while, that’s fine too.

It’s important that you keep that milk flowing with a breast pump while you’re taking a break from breastfeeding. Ensuring your milk supply stays steady until you can nurse again.

Don’t forget to throw away any pumped milk during this time.

So, here’s the bottom line: You shouldn’t have to choose between your health and your baby’s.

With proper guidance from your healthcare provider and a little planning, you can safely take medications while breastfeeding.

To know more about what you can or cannot do while breastfeeding, check out my post here.

Love,
Shely

Disclaimer: I am not a doctor. This post is for informational purposes only and should not replace medical advice. Always consult with your healthcare provider before taking any medication while breastfeeding.