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HealthInfo Canterbury

Taking medication while breastfeeding

When it comes to taking medication while breastfeeding, there is a lot of confusing and conflicting information around. This often leads to women either not taking medication that they need or giving up breastfeeding when they don't have to. With the right knowledge and advice, you can make decisions that will benefit both you and your baby.

It is true that some of the medication you take will pass into your breast milk and therefore can be passed on to your baby. The amount that will be passed on to your baby very much depends on the type of medication and how it is absorbed in your body. It is important to remember that your baby also has systems in their body to process and excrete medication, so in most cases a small dose of safe medication will do them no harm.

In the first three days after birth you are more likely to absorb medication into your milk and pass it on to your newborn. When babies are this young they also have less capacity for processing drugs in their system. If you need to take any medication at this time you should first consult your general practice team, midwife or pharmacist.

Stepwise approach to taking medication while breastfeeding

If you think that you may need to take medication while breastfeeding, the following stepwise approach can help you minimise your baby's exposure to medication. Talk to your general practice team or pharmacist if you have any concerns.

If you need to take medication, consider the following:

To be avoided while breastfeeding

Recreational drugs: Although this may seem obvious, if you take recreational drugs (including cannabis) you need to be aware of the harm this can do to your baby. Since doses of recreational drugs are unregulated, it is difficult to know how much of the drug is passing into your milk. These drugs can stay in your baby's system for many hours and can cause sleepiness, agitation, breathing problems and potentially brain damage. If you have taken a recreational drug, it is better to use an alternative form of feeding and seek advice about when it is safe to continue breastfeeding.

Alcohol: Compared to other drugs, alcohol is easily absorbed into breast milk. If you are planning to drink alcohol, read this information to help with your feeding plan.

Smoking: Smoking is not advisable while breastfeeding because it reduces milk production and decreases the fat content of milk. It also affects your baby's health.

Caffeine: Caffeine is in coffee, tea, cola drinks, energy drinks, chocolate, some herbal products and some medicines. Occasional caffeine intake while you are breastfeeding is unlikely to cause problems but it is best to avoid regular consumption. Caffeine can make your baby irritable and alter their sleep patterns. Some babies, particularly those under six months, are more sensitive to caffeine, so if your baby is bothered when you have even a small amount of caffeine, you might want to stop consuming caffeine for a while to see if that makes a difference. Your baby's sensitivity to caffeine will usually become less of an issue as they get older.

Common over-the-counter (OTC) medications

Talk to a pharmacist before taking any OTC medications (including any herbal or natural products) while you are breastfeeding. The following is a list of some common conditions and medications that are known to be safe (and those to avoid):

Condition

Safe

Avoid

Pain relief

Paracetamol (first choice), ibuprofen, small dose of codeine

Aspirin, naproxen, extra-strength or combination preparation drugs

Colds

Saline nasal spray and steaming, paracetamol, short course Otrivin decongestant

Pseudoephedrine (reduces milk production significantly), combination preparation drugs

Allergy and hay fever

Saline nasal wash or spray, Flixonase nasal spray, sodium cromoglycate eye drops, loratadine, fexofenadine

Pseudoephedrine, promethazine

Skin and thrush

Clotrimazole, Micreme, hydrocortisone cream, moisturisers, aciclovir cream (for cold sores)

Fluconazole tablets (inadequate evidence of safety)

Indigestion or constipation

Gaviscon/Mylanta, lactulose, Metamucil

Senna, omeprazole

Infection

Bactroban ointment, penicillins and erythromycin (prescription only)

 

Where can I find out more about taking medication while breastfeeding?

  HealthInfo recommends the following pages

Talk to your general practice team for more information and visit the following websites:

Page reference: 57555

Review key: HIBRF-24381