Most medicines are safe to take while you are breastfeeding. However, some medicines enter your breast milk and can affect your baby, so get advice from your doctor, midwife or pharmacist before taking any medicines.
Mothers are often concerned about taking medicines while breastfeeding. This may lead to women choosing to stop breastfeeding unnecessarily or not taking medicine you may need.
However, don't give up on breastfeeding just because you need to take medicine – instead find out whether it is safe to keep breastfeeding. And never stop any medicine suddenly. Check first with your doctor or pharmacist as stopping some medicines suddenly can be dangerous and make you unwell.
| This article is intended as a general guide only. Get advice from your pharmacist, midwife or doctor if you have any questions or concerns. |
Do medicines pass into breast milk?
Most medicines are safe to take while you are breastfeeding because they don't pass into your breast milk. Even if the medicine does enter your milk, it is usually in such a small amount that it won't affect your baby.
However, some medicines do enter your breast milk. The effect on your baby depends on the age and health of your baby, the type of medicine, how much you take and when you take it.
Before your doctor prescribes a medicine for you, make sure they know you are breastfeeding.
Breastfeeding mothers rarely have to stop breastfeeding due to taking medicine. However, it is important you get advice from your doctor or pharmacist. They will help you to weigh up the risks and benefits of taking the medicine with any risks for your baby.
You should take special care if your baby was premature, is sick or is taking medicine themselves.
Steps for taking medicine safely while breastfeeding
If you think you may need to take medicine while breastfeeding, working through the following steps can help to keep your baby safe. Talk to your doctor, midwife, Plunket nurse or pharmacist if you have any concerns.
1. Avoid any medicine that's not essential
Use medicine only when you need it and it's important to your health. Avoid any medicine that's not essential.
2. If you need relief, try a non-drug option
Here are a few examples:
- Pain: It's safe to take paracetamol and ibuprofen while breastfeeding, as long as you take the correct dose. But if your pain is not too bad, try using relaxation techniques, massage or warm baths instead.
- Coughs, colds and allergies: Instead of cough, cold and allergy medicines, try avoiding things you know you're allergic to and using saline nose drops, cool mist or steam. Many cold remedies have ingredients that you should avoid as some of them can reduce your milk supply.
- Tummy problems: Instead of medicines for gastric reflux, try eating small meals, sleeping with your head propped up and avoiding gas-forming foods. Instead of constipation relief medicines, try eating high-fibre cereal or prunes and drinking Kiwi Crush and plenty of water.
3. If you do need to take medicine, talk to your GP or pharmacist first
They can advise you on choosing the right medicine and on how to do the following:
- Take the lowest recommended dose for the shortest time possible.
- Avoid extra-strength or long-acting medicines for short-term conditions, and medicines with more than one ingredient.
- Take the medicine in a form that doesn't enter your milk or only in minimal amounts. For example, it may be available as a cream, ointment or spray.
- Feed your baby just before you take the medicine, as this limits the amount passed into your breast milk.
Are there medicines I should avoid when breastfeeding?
There are some situations where the medicine is necessary but too harmful for you to continue breastfeeding, such as chemotherapy. If you need to take on of these medicine long-term, you will need to find other options to feed your baby safely:
- some anticancer medicines (chemotherapy)
- some immunosuppressants (with exceptions, eg, azathioprine in some circumstances)
- gold salts
- amiodarone
- lithium
- ergotamine.
Read more: What to do if you can't breastfeed and feeding your baby infant formula.
What effect do medicines have on milk supply?
Some medicines can reduce or increase your milk supply.
The combined oral contraceptives are best avoided in the early stages of breastfeeding because oestrogen (usually ethinyloestradiol) reduces milk supply. Breastfeeding women who need to take an oral contraceptive are usually prescribed a progestogen-only pill.
Learn more
Return to babies and breastfeeding
Medications and breastfeeding Ministry of Health, NZ
Drugs factsheets The Breastfeeding Network, UK
Leaflets A to Z Best Use of Medicines in Pregnancy (BUMPS), UK
Fact Sheets Mother to Baby, US
References
- Medicines and breastfeeding Medsafe, NZ, 2015
- Prescribing considerations in contraception, conception, pregnancy, and breast-feeding NZ Formulary
- Breastfeeding – evidence based guidelines for the use of medicines RACGP, 2011