A woman’s lifestyle may affect her breast milk, and impact the baby’ health. Mothers should talk to their doctor before taking medications because small amounts can pass through the breast milk. Mothers can use this information to educate themselves about the consequences of taking medications and about seeking a doctor’s advice to make sure the medications are safe.
Always talk with your doctor before taking any medications. Most medications pass into your milk in small amounts. If you take medication for a chronic condition such as high blood pressure, diabetes or asthma, your medication may already have been studied in breastfeeding women, so you should be able to find information to help you make an informed decision with the help of your doctor. Newer medications and medications for rare disorders may have less information available. The American Academy of Pediatrics has information about many prescription and over-the-counter medications posted on their web site at: http://www.aap.org/.
In general, when breastfeeding it is safe to take:
- acetaminophen (like Tylenol)
- epilepsy medications (although one, Primidone, should be taken with caution—talk with your doctor about this drug)
- most antihistamines
- moderate amounts of caffeine (remember there is caffeine in soda and in chocolate)
- ibuprofen (like Advil)
- thyroid medicines
- progestin-only birth control pills (the "mini-pill")
Medications that are not safe to take when breastfeeding:
Some drugs can be taken by a nursing mother if she stops breastfeeding for a few days or weeks. She can pump her milk and discard it during this time to keep up her supply. During this time, the baby can drink her previously frozen breast milk or formula. These drugs include radioactive drugs used for some diagnostic tests like Gallium-67, Copper 64, Indium 111, Iodine 123, Iodine125, Iodine-131, radioactive sodium, or Technetium-99m, antimetabolites, and a few cancer chemotherapy agents.
There are drugs that if new mothers have to take them, they need to choose between taking them or breastfeeding.
Some of these drugs that should never be taken while breastfeeding include:
- Bromocriptine (Parlodel) - a drug for Parkinson's disease, it also decreases a woman's milk supply.
- Cyclophosphamide, Doxorubicin, and most chemotherapy drugs for cancer - these drugs kill cells in the mother's body and may harm the baby.
- Ergotamine (for migraine headaches); Methotrexate (for arthritis); and Cyclosporine (for severe arthritis and psoriasis, aplastic anemia, Crohn's disease, kidney disease, and for after organ transplant surgery).
Drugs whose effects on nursing infants is not known but may be cause for concern include:
- Antianxiety drugs - Alprazolam, Diazepam, Lorazepam, Midazolam, Perphenazine, Prazepam, Quazepam, Temazepam.
- Antidepressant drugs - Amitriptyline, Amoxapine, Bupropion, Clomipramine, Desipramine, Dothiepin, Doxepin, Fluoxetine, Fluvoxamine, Imipramine, Nortriptyline, Paroxetine, Sertraline, Trazodone.
- Antipsychotic drugs - Chlorpromazine Galactorrhea, Chlorprothixene, Clozapine, Haloperidol, Mesoridazine, Trifluoperazine.
Other drugs - Amiodarone, Chloramphenicol, Clofazimine, Lamotrigine, Metoclopramide, Metronidazole, Tinidazole.