Medication use while breast-feeding

Prescription and nonprescription medications

Talk to your health professional before taking any prescription or nonprescription medication while breast-feeding. Some medications that enter the breast milk may harm your baby. However, many medications are safe to use while breast-feeding, including certain pain relievers, antibiotics, antidepressants, anticoagulants, and endocrine medications (such as insulin). Consider the following before taking medications while breast-feeding:

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

Talk to your health professional about temporarily discontinuing breast-feeding if you must take a medication that is not safe for your baby. If you are going to take this medication in a single dose or for a relatively short time (1 or 2 weeks), bottle-feed formula to your baby, but maintain your milk supply by pumping your breasts and discarding the milk. When the medication has left your system, you can resume breast-feeding your baby.

Alternative remedies

Although domperidone is available in some countries for intestinal problems, this medication is not approved for any use in the United States. Domperidone can increase a breast-feeding woman's milk supply. For this reason, some women obtain the medication. The U.S. Food and Drug Administration (FDA) warns breast-feeding 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 breast-feeding infant.¹

Some breast-feeding 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 medications, do not take herbs without first consulting with your health professional. 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 necessary because the strength of an herbal tea or product depends upon how it is prepared. The actual amount of an herb consumed is very difficult to predict or study.

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: http://www.fda.gov/bbs/topics/ANSWERS/2004/ANS01292.html.