Medication dos and don’ts while breastfeeding

Is it safe to take a tablet if you have a headache? Or those vitamins you lived on pre-conception? Here’s everything you need to know about taking meds while breastfeeding. By Robyn Forrester

By Robyn Forrester

How meds can affect your milk supply

What you eat, drink and ingest all goes into your breastmilk, so it’s guaranteed that any medication you take will follow the same route. A general rule of thumb, however, is that 1% of the medication you take will find its way into your milk.
The doses your baby might ingest through your breastmilk aren’t likely to be high, but since he’s so tiny, even that small percentage could have a negative effect.
And what you were allowed to take during pregnancy may not be safe while breastfeeding.
Generally, the medications which are safe for your baby, will be safe for you. But if you need to take an over-the-counter medication for, say, a cough, choose one that only has one active ingredient. Ask your pharmacist for advice.

Energy drinks, nicotine, caffeine and alcohol

  • If you’re battling with fatigue, it’s best not to take energy drinks for a boost, as they contain high levels of caffeine. Rather discuss alternatives with your doctor.
  • Avoid smoking, but if you do, don’t smoke near your baby and only smoke after you’ve fed him. Nicotine can cause low milk supply, and nausea, vomiting, cramps or diarrhoea in babies.
  • Moderate alcohol is okay, but only breastfeed two hours after. Too much alcohol can affect milk production, and his growth and development.
  • More than moderate caffeine intake could cause your baby to be irritable and sleep poorly. Check all the beverages you drink for caffeine.

Prescribed medications – what’s safe to use?

Allergic Rhinitis
Side effect: Medications containing pseudophedrine are excreted in breastmilk and can cause tiredness or irritability in your baby.

Side effect: Insulin isn’t excreted into breastmilk, but it’s best to avoid metformin and thiazolidinediones, as the safety of these hasn’t been established for breastfeeding moms.

Side effect:
Inhaled asthma medication is generally safe for breastfeeding moms, but try to avoid feeding four hours after taking a dose.

Side effect:
Beta blockers differ in how much they’re excreted into breastmilk, but are generally safe if you’re taking low doses of one that doesn’t infuse into your milk.

Side effect:
Anticonvulsants are excreted into breastmilk, but are mostly considered safe for breastfeeding moms. Your doctor will recommend regular blood tests to ensure that the medication doesn’t reach toxic levels for you and your baby.

Side effect:
SSRI antidepressants are considered the safest for breastfeeding moms, and taking the dose after the last night feed is the best time.

Side effect:
Painkillers containing ibuprofen are seen to be the safest for breastfed babies, but limit your intake.

Side effect:
Oral contraceptives are considered safe, but the added oestrogen could limit milk production.

If you need medication for conditions like depression, thyroid problems or blood pressure, speak to your doctor about the lowest possible dose, and the timing. To allow your body to metabolise and use up the medication as much as possible before the next feed, time your dose for after his feed, and make sure the period until the next feed is the longest one.

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