Medications and Breastfeeding

Spilled bottle of ibuprofen pills on a white background

Medications and breastfeeding is a common question I get from moms, new and experienced. There are many safe medications to take while breastfeeding. I use Thomas Hale’s “Medications and Mother’s Milk” as my reference. It is updated every two years and gives us all the current research and studies on medications with breastfeeding.

Many of the safe medications are the same ones you might have taken during pregnancy. One of those exceptions is Motrin, also called Ibuprofen or Advil. This can not be taken in pregnancy but is safe with breastfeeding. Another guideline is that if a medication can be safely given to an infant, mom can probably take it while breastfeeding.

Cold Medication

What if you get a cold and need to take a medication? Some cold medications can be okay, but combination ones should be avoided. Some of the ingredients, such as Tylenol (Acetaminophen), are okay to take but others may not be safe. Cold medications with Benadryl (Diphenhydramine) will not affect your milk supply but may make baby sleepy. Ones with Sudafed (Pseudoephedrine) can decrease your milk supply in addition to making your baby fussy and irritable. You can find more detailed information about those two medications here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884328
http://www.infantrisk.com/content/over-counter-treatments-cough-and-cold

Most importantly, mothers with a cold need to get their rest. If a mom takes a cold medication once at night and is able to sleep better, she will probably feel better the next day. If a cold medication is taken one time, it will also have less effect on baby or mom’s milk supply. In order to minimize the amount of medication transferred to baby, it is also helpful to take it after baby has just nursed.

Pain Medication

Motrin and Tylenol are always safe to take with breastfeeding. Most moms will take some stronger pain medications after delivery such as Percocet or Hydrocodone. These are okay if not taken too long, too frequently or too many at a time. We expect moms to be taking pain medications every four hours or so soon after delivery but she shouldn’t be taking two Percocet every four hours for two weeks after delivery. Pain medications can also be taken safely after dental procedures or unexpected surgeries. It’s still better to follow the rule to take the medication after nursing and not be taking them too often over too long of a time period.

General Anesthesia

General anesthesia is another misunderstood area. When you wake up from a general anesthetic, it is out of your system and therefore out of your breastmilk. It is not necessary to pump and dump after having a general anesthetic. You can start breastfeeding again after a surgical procedure when you are physically feeling well enough. If you have other medications involved that the doctor tells you to pump and dump, call me and I’ll let you know what Thomas Hale says.

Antidepressants

Antidepressants are another medication that raises concerns. One of the most commonly given is Zoloft which is safe with breastfeeding. There are several other safe options to choose from if Zoloft doesn’t work for a mom. Again, you can call me and I’ll look it up for you to see what Thomas Hale says.

Whenever a breastfeeding mom needs to take a medication, the risks and benefits need to be weighed. If it’s very beneficial for mom and has minimal risk to baby, it’s probably okay to take. Moms can call me about medications and I can look them up to see what Thomas Hale recommends. But the final decision needs to be made by a mom and her doctor on whether a particular medication is a good choice for her to take with her breastfed baby.

If you have additional questions regarding breastfeeding and medication, don’t hesitate to give me a call or send me an email.

Diane Erdmann RN BSN IBCLC
Breastfeeding Support & Supplies
402-707-1696

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