What are the effects of medicines on breastfeeding mothers?

Administration of medicines during breastfeeding may sometimes be necessary to the mother. Most drugs pass through the bloodstream and will be present in small amounts in the mother’s milk. To minimise your baby’s exposure to drugs you will need to discuss your medicine with your doctor or pharmacist.

How can you minimise your infant’s exposure to medication?

• Inform your doctor that you are breastfeeding your baby whenever you seek treatment
• Withhold any medicine that is not essential
• Withhold breastfeeding temporarily if necessary
• Take your medication immediately after your baby has been fed to ensure the lowest level of medicine in the milk at the next feeding.
• Take the medicine before the infant’s longest sleep period

What are the precautions you should take?

• Check with your doctor or pharmacist before taking any medicine
• If you have to take a medicine while breastfeeding, have the baby checked regularly for any adverse effects that may occur.
• Use reliable references for obtaining information on medications in breast milk
• Medications that are safe in pregnancy are not always safe in breast-feeding mothers

Commonly used medicine taken during breastfeeding

Medicine	Comments
Pain relievers and Analgesics	No known harmful effects with occasional use Use with care. Discuss with pharmacist or doctor
Paracetamol NSAIDS (Non-steroidal anti-inflammatory drugs) (e.g. diclofenac, mefenamic acid, naproxen)
Antihistamines	Use is not recommended. May lessen milk supply and cause irritability in baby. Discuss with pharmacist or doctor.
Chlorpheniramine, loratadine
Antacids	No known harmful effects
Mylanta, Maalox, Gelusil
Antidiarrhoeals		No known harmful effects Use with care. Discuss with pharmacist Use is not recommended
Kaolin Loperamide Atropine with diphenoxylate
Cough and cold preparations	No known harmful effects Use with care. Discuss with pharmacist Use with care. May lessen milk supply and cause irritability in baby. Discuss with pharmacist or doctor
Dextromethorphan Pholcodeine Pseudoephedrine
Inhaled bronchodilators for asthma	No known harmful effects.
Salbutamol, Terbutaline Inhaler
Laxatives	No known harmful effects May cause diarrhoea in baby
Bulk forming Julap perangsang
Worm medications	No known harmful effects Use is not recommended
Pyrantel pamoate Mebendazole/Albendazole
Miscellaneous	No known harmful effects with recommended dosage
Iron preparations for anaemia
Iodides	Do not use – may affect thyroid gland. If need to use, stop breastfeeding
Nicotine (for smoking cessation)	Can lessen milk supply, cause vomiting, diarrhoea and restlessness in the baby
Vitamins ( A, B, C, D, E, K )	Take care with vitamins A, D and E in large doses
Caffeine	Large amounts of caffeine may cause irritability in baby

Harmful substances