My doctor has prescribed a medication for me. Is it safe for me to continue breastfeeding my baby while I take the medicine?
You are wondering if you should take the medication that your doctor has prescribed. It's easier to make that decision when you have information on breastfeeding and medications. Breastfeeding is important to you and your baby. It is prudent to investigate taking any medications, even ones available without a prescription. (Herbal remedies should also be researched.) LLLI WOMANLY ART OF BREASTFEEDING, says on page 312, "When prescribing a medication for a nursing mother, some physicians routinely insist on weaning as a precaution. In reality, few drugs have been proven to be harmful to the nursing infant." Sudden weaning is traumatic for mother and baby and can lead to additional health and emotional risks for both. Your health care provider needs to know that you are breastfeeding and that you want to continue doing so.
There are many variables to consider when a breastfeeding mother is prescribed a medication. For example, the baby's age needs to be taken into consideration. An older baby who is breastfeeding less frequently would consume smaller amounts of breastmilk and thus have less exposure to medication through mother's milk. Here are some questions to begin a dialogue with your health care provider. (They are from the LEAVEN article "Medications and Breastfeeding".)
- Has the drug been given to infants? A drug commonly prescribed for infants is usually a good choice for a breastfeeding mother.
- Has the drug been given to other breastfeeding mothers? A drug that has a history of use by breastfeeding mothers is a better choice than a new, possibly untested drug.
- What is the duration of the drug therapy? The duration of the drug therapy can affect its compatibility with breastfeeding. A drug considered compatible with breastfeeding when taken for a few days might not be compatible when taken over a long period of time.
- Is the drug short-acting? A short-acting form of the drug may be a better choice for a breastfeeding mother than a longer-acting form that stays in the mother's system for a longer period.
- How is the medication being given? A drug given by injection or by mouth is less concentrated than one given intravenously. However, a drug may be given intravenously because it is inactivated or not absorbed by the digestive system, so the baby's digestive system would also inactivate or not absorb the drug.
- How well can the baby excrete the drug? Some drugs accumulate in a baby's system and can potentially build to toxic levels. A drug that is quickly eliminated by the baby is more compatible with breastfeeding.
- Does the drug interfere with lactation? Some drugs should be avoided by breastfeeding mothers because they affect breastfeeding itself (the let-down or milk supply).
Your local La Leche League Leader has access to the publications listed below, as well as others that may assist you and your health care provider in researching the information available about a particular medication.
Resources for Additional Information
Can I Breastfeed My Baby If I Am Sick? Another FAQ article.
Maternal Medications and Breastfeeding, NEW BEGINNINGS article by Gwen Gotsch.
Medication and Breastfeeding, LEAVEN article by Pat Sturges.
An abstract of the September 2001 Policy Statement of the American Academy of Pediatrics entitled, "The Transfer of Drugs and Other Chemicals Into Human Milk", can be found on the American Academy of Pediatrics Web site.
These items may be available from the LLLI Online Store or from your local Leader:
When a Nursing Mother Gets Sick: This pamphlet explains why breastfeeding can continue even if a mother gets sick; discusses the effects of medications on the nursing baby.
THE WOMANLY ART OF BREASTFEEDING, published by La Leche League International, is the most complete resource available for the breastfeeding mother. It contains a section on breastfeeding while ill.
Breastfeeding: A Guide for the Medical Profession, 5th edition, by Ruth Lawrence, MD and Robert Lawrence MD. The classic reference book includes management techniques for handling breastfeeding in adverse conditions and up-to-date information on medications and human milk. It remains one of the most comprehensive breastfeeding resources available.
La Leche League International BREASTFEEDING ANSWER BOOK, by Nancy Mohrbacher and Julie Stock. This popular LLLI resource book includes a whole chapter on health issues in the mother and an appendix with the full text of the AAP policy statement "The Transfer of Drugs and Other Chemicals Into Human Milk."
Medications and Mothers' Milk, 12th Edition, 2006 by Thomas Hale, Ph.D. Revised and updated every year, this popular reference is complete, easy to read, easily portable, and affordable. Contains reviews of medications, vaccines, viruses, and herbal preparations. The reviews include AAP recommendations as well as adult and pediatric concerns and side effects.