Wondering about breast-feeding and medications? Know how medications can affect your breast milk and which drugs are safe to take. By Mayo Clinic Staff

If you're breast-feeding, you know you're giving your baby a healthy start. However, if you need to take medication while you're breast-feeding, you might have questions about the possible impact on your breast milk.

Here's what you need to know about medications and breast-feeding.

Almost any drug that's present in your blood will transfer into your breast milk to some extent, although the level of medication in your breast milk is likely to be low. There are exceptions, though, in which drugs can become concentrated in breast milk. As a result, every medication must be considered separately.

Yes.

Exposure to medication in breast milk poses the greatest risk to premature babies, newborns, and babies who are medically unstable or have poorly functioning kidneys. The risk is lowest for healthy babies 6 months and older.

Most medications are safe to take while breast-feeding. Also, the benefit of continuing to take a medication for a chronic condition while breast-feeding often outweighs any potential risks.

Still, some medications aren't safe to take while breast-feeding.

If you currently take a medication that could be harmful to your baby, your health care provider might be able to recommend a safe alternative medication. If not, he or she might recommend that you stop breast-feeding temporarily or permanently — depending on how long you need to take the medication.

If you need to stop breast-feeding only temporarily, use a breast pump to keep up your milk supply until you're able to breast-feed again. Simply discard the milk you pump while you're taking the medication.

If you need to stop breast-feeding permanently — which is unusual — ask your health care provider to help you choose an infant formula that will meet your baby's needs.

With your health care provider's input, consider this list of medications found to be safe during breast-feeding. Keep in mind that this isn't a comprehensive list of safe medications.

Pain relievers

  • Acetaminophen (Tylenol, others)
  • Ibuprofen (Advil, Motrin IB, others)
  • Naproxen (Aleve, Naprosyn, others) — short-term use only

Antimicrobial medications

  • Fluconazole (Diflucan)
  • Miconazole (Monistat 3, Micaderm, others)
  • Clotrimazole (Mycelex, Lotrimin, others)
  • Penicillins (amoxicillin, ampicillin, others)
  • Cephalosporins (Keflex, Duricef, others)

Antihistamines

  • Loratadine (Claritin, Alavert, others)
  • Fexofenadine (Allegra)

Decongestants

  • Saline nasal drops
  • Medications containing pseudoephedrine (Sudafed, Zyrtec D, others) — use with caution because pseudoephedrine can decrease milk supply

Birth control pills

  • Progestin-only contraceptives, such as the minipill

New research suggests that combination birth control pills, oral contraceptives that contain estrogen and a progestin, don't affect milk production. Still, consider waiting until breast-feeding is firmly established — about six to eight weeks — before using this type of birth control pill.

Gastrointestinal medications

  • Famotidine (Pepcid)
  • Omeprazole (Prilosec)
  • Cimetidine (Tagamet)

Antidepressants

  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Fluvoxamine (Luvox)

Constipation medications

  • Docusate sodium (Colace)

If you plan to take medication while breast-feeding, it's always best to check with your health care provider first.

Avoid taking medications that aren't necessary, such as herbal medications, high-dose vitamins and unusual supplements.

Also ask about the timing. For example, taking medication immediately after breast-feeding might help minimize your baby's exposure. However, different drugs peak in breast milk at different times.

When you're taking medication, be sure to watch your baby for any unusual signs or symptoms — such as a change in eating or sleeping habits, fussiness or a rash. If you notice any change in your baby's behavior, contact his or her doctor.

Jul. 26, 2012