Topic Overview

Prescription and nonprescription medications

Talk to your doctor before you take any prescription or
nonprescription medicine while breastfeeding. That’s because some medicines can affect your breast milk.

But many medicines are safe to use when
you breastfeed. These include certain pain relievers (such as acetaminophen and ibuprofen), cold and flu medicines, antibiotics, antidepressants,
anticoagulants, and diabetes medicines (such as insulin). Decongestants with pseudoephedrine (such as Sudafed) are safe to use, but they can reduce breast milk supply.

Consider the
following before taking medicines while breastfeeding:

  • Use the safest medicine available. Some
    medicines have alternatives that are safer for breastfeeding mothers. Ask
    for the medicine that produces the lowest, safest levels of the drug in
    breast milk.
  • Avoid using long-acting forms of nonprescription
    medicines. Medicine levels may build up quickly in the
    infant.
  • Ask your doctor or pharmacist about the best time to take
    your medicine to minimize the effect on your baby. This is often just after a
    feeding.
  • Watch for medicine side effects in your infant. Tell your doctor about any fussiness, rash, changes in feeding or sleeping patterns, or other concerns.

Talk to your doctor about temporarily discontinuing
breastfeeding if you must take a medicine that is not safe for your baby. If
you are going to take this medicine in a single dose or for a relatively
short time (1 or 2 weeks), bottle-feed formula to your baby, but keep up your
milk supply by pumping your breasts and discarding the milk. When the
medicine has left your system, you can go back to breastfeeding your
baby.

Alternative remedies

Although domperidone is available in some countries for intestinal
problems, this medicine is not approved for any use in the United States.
Domperidone can increase a breastfeeding woman’s milk supply. For this reason,
some women obtain the medicine. The U.S. Food and Drug Administration (FDA)
warns breastfeeding women not to take domperidone because of its potential
dangerous side effects (such as irregular heartbeat and sudden death). Also,
the drug has unknown effects on the breastfeeding infant.footnote 1

Some breastfeeding women try herbal remedies for problems, such as
to increase milk supply. Common herbs used for these purposes include
fenugreek, fennel, or various herbal teas. As with any medicines, do not take
herbs without first talking with your doctor. The effects of
most herbal remedies on babies are unknown. Some experts advise that some herbs
(including fenugreek, fennel, comfrey leaf, and borage) may harm the baby.
Herbs may also cause allergic reactions in the mother or the baby.

With herbal teas or preparations, even more caution is needed,
because the strength of an herbal tea or product depends upon how it is
prepared. The actual amount of an herb consumed is very hard to predict or
study.

Other Places To Get Help

Organizations

La Leche League International
www.llli.org

U.S. Department of Health and Human Services: Women’s Health
www.hrsa.gov/womenshealth/index.html

References

Citations

  1. U.S Food and Drug Administration (2004). FDA warns against women using unapproved drug, domperidone, to increase milk production. FDA Talk Paper T04-17. Available online: https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm173886.htm.

Credits

ByHealthwise Staff
Primary Medical Reviewer Sarah Marshall, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Adam Husney, MD – Family Medicine
Elizabeth T. Russo, MD – Internal Medicine
Specialist Medical Reviewer Kirtly Jones, MD – Obstetrics and Gynecology

Current as ofJune 5, 2017