HealthInfo Waitaha Canterbury
Medicines, alcohol, drugs & breastfeeding
There is a lot of confusing and conflicting information about taking medicines when breastfeeding. This often leads to women either not taking medicine they need or giving up breastfeeding when they do not have to.
Some medicines will pass into your breast milk. The amount your pēpi (baby) receives depends on the type of medicine, how your body absorbs it, when you take it and how old your pēpi is. Premature and low-birth-weight pēpi may have more problems than other pēpi. Your pēpi can also process and excrete some medicine, so small doses of most medicines will do them no harm.
The benefits of breastfeeding your pēpi are huge, and in most cases it's safe to continue breastfeeding while you take medicine.
Safely taking medicine while breastfeeding
If you think you may need to take medicine while breastfeeding, the following things can help to keep your pēpi
baby
safe. Talk to your GP, practice nurse, pharmacist or lactation consultant if you have any concerns.
Avoid any medicine that is not essential. Try non-drug therapies.
- It's safe to take paracetamol and ibuprofen while breastfeeding if you stick to the correct dose. But if your pain is not too bad, try using relaxation techniques, massage or warm baths instead.
- Instead of cough, cold and allergy medication, try avoiding things you know you're allergic to and using saline nose drops, cool mist or steam.
- Instead of medication for gastric reflux, try eating small meals, sleeping with your head propped and avoiding gas-forming foods.
- Instead of constipation relief medication, try eating high-fibre cereal or prunes, drinking Kiwi Crush and drinking plenty of water.
- Instead of medicine for diarrhoea, try avoiding solid food for 12 to 24 hours, drinking more and eating toast or dry crackers.
Only use medicine when you need it and it's important to your health.
If you need to take medicine, talk to your GP or pharmacist about these ideas.
- Taking the lowest recommended dose for the shortest time possible. Avoid extra-strength or long-acting drugs and medicines with more than one ingredient. Many cold remedies have combination ingredients that you should avoid, as the decongestant in them can reduce your milk supply.
- Taking the medicine in a form that reduces how much your milk absorbs. For example, it may be available as a cream, ointment or spray.
- Breastfeeding when the medicine is at lower levels in your breast milk. One way to do this is to breastfeed just before taking it.
- Taking the medicine before your baby's longest sleep period. This will minimise how much your pēpi gets and is useful for long-acting drugs that you take once a day.
It's rare that you would need to stop breastfeeding altogether. In a few cases, the medicine (for example, chemotherapy) is too toxic to continue breastfeeding.
If you need to take a medicine that prevents you breastfeeding long-term, you'll need to feed your pēpi another way. Read this information about formula feeding and get support from your health professional and a lactation consultant to guide you.
Substances to avoid while breastfeeding
Recreational drugs: Although this may seem obvious, recreational drugs (including cannabis) can harm your pēpi baby . Because there is no control over the amount of active ingredients in recreational drugs, there is no way of knowing how much is in 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've taken a recreational drug, it's better to feed your pēpi another way (stored or donated breast milk or formula) and ask your midwife or GP about when it's safe to breastfeed again.
Alcohol: When you drink alcohol, you easily absorb it into your breast milk – the level of alcohol in your breast milk is about the same as in your blood. If you're planning to drink alcohol, read this information to help with your feeding plan. The Feed Safe app helps you to figure out when your breast milk will be free of alcohol. It's free to download.
Smoking: It's best to stop smoking when you're breastfeeding, because it affects you and your baby's health. But if you do smoke, it's much better for your pēpi to be breastfed than not to be breastfed at all. Breast milk helps to strengthen your baby’s immune system from infections that are more common in smoking households, like chest and ear infections.
You can minimise the risk to your pēpi by smoking after breastfeeding, only smoking outside and by using a smoking jacket (a jacket you put on when you're smoking and take off afterwards, then leave outside). This helps to reduce the amount of smoke on your clothes that your pēpi comes into contact with.
You can read more information about why second-hand smoke is bad for your baby. Also read How to become smokefree for a list of free or cheap resources to help you quit smoking.
Caffeine: Caffeine is in coffee, tea, cola drinks, energy drinks, chocolate, some herbal products and some medicines. Having a bit of caffeine every now and then is unlikely to cause problems, but it's best to avoid having a lot when you're breastfeeding. In some cases, caffeine can make your pēpi irritable and alter their sleep patterns.
Some pēpi, particularly those under six months, are more sensitive to caffeine. If your pēpi is bothered when you have even a small amount of caffeine, you might want to stop having any for a while to see if that makes a difference. Your pēpi will probably become less sensitive to caffeine 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're breastfeeding. The following is a list of some common conditions and medications that are safe (and those to avoid):
Condition |
Safe |
Avoid |
|---|---|---|
Pain relief |
Paracetamol (first choice), ibuprofen |
|
Colds |
Saline nasal spray and steaming, paracetamol |
Pseudoephedrine (prescription only), combination preparation drugs |
Allergy and hay fever |
Saline nasal wash or spray, Flixonase nasal spray (fluticasone), sodium cromoglycate eye drops, loratadine, fexofenadine |
Pseudoephedrine (prescription only) |
Skin and thrush |
Clotrimazole, MICREME H, hydrocortisone cream, moisturisers, aciclovir cream (for cold sores) |
|
Indigestion or constipation |
Gaviscon/Mylanta, lactulose, Metamucil |
|
Infection |
Bactroban ointment, penicillins and erythromycin (prescription only) |
Ciprofloxacin (prescription only), tetracycline (prescription only) |
Talk to your GP if you need more information.
HealthInfo recommends the following pages
- The Breastfeeding Network – Drug factsheets
This page has links to factsheets about many different drugs and medical conditions and how they affect breastfeeding.
- InfantRisk Centre
Advice about the effect of drugs on breastfeeding from the Texas Tech University Health Sciences Center, School of Medicine, Department of Pediatrics in Amarillo.
- National Library of Medicine – Drugs and lactation database
Information on drugs and other chemicals to which breastfeeding mothers may be exposed, along with suggestions for safe alternatives where appropriate.
- MotherToBaby – Factsheets
Individual factsheets about specific medicines and their effect on you and your pēpi when you're pregnant or breastfeeding.
Written by HealthInfo clinical advisers. Last reviewed December 2021.
SourcesReview key: HIBRF-24381
