Medications While Breastfeeding

General Principles

  • Most medications are compatible with breastfeeding
  • If it is a medication your child can take, you can take it while breastfeeding
  • When considering medications and breastfeeding the questions physicians ask include:
    • How easily does the medication get into the breast milk
    • How well is it absorbed in the intestinal tract
    • How long does it take for the medication to be removed from your body (i.e. the drug’s half life)
    • How does the infant’s medication exposure compare to the maternal dose of the medication
  • If the medication can only be taken intravenously (i.e. it is not absorbed orally) then even if it makes it into your breast milk it will most likely be destroyed by your infant’s GI tract
  • Click here for a list of common medications that are compatible with breastfeeding from Senders Pediatrics
  • Lactmed Toxnet Database: is an excellent database of the current knowledge of medications and breastfeeding.  This can be a helpful resource when reviewing medications and breastfeeding with your provider
  • Infant Risk Center: 806- 352-2519 is maintained by Dr. Thomas Hale, an expert on medications and breastfeeding.  They also have a mobile app
  1. Can I Drink Alcohol & Breastfeed?

    Yes, in general alcohol concentration in breast milk is similar to your blood level.  If you are intoxicated you should not breastfeed.  In general a glass of wine with dinner is fine.

    Per the American Academy of Pediatrics section on breastfeeding: “ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60 kg mother is approximately 2 oz liquor, 8 oz wine, or 2 beers. Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.” Click here for full article.

  2. What About Birth Control & Breastfeeding?

    Combination estrogen and progesterone contraception should be avoided while breastfeeding as estrogen is known to decrease milk production.

    There is controversy regarding progesterone only contraception (mini-pill, depo-provera) impacting milk supply. Further research is  needed to answer this question. Many women have breastfed successfully while on progesterone only contraception. Anecdotally, some women’s milk supply will decrease. Until future research answers this question, it seems prudent to at least allow your milk supply to be established and avoid hormonal contraception in the immediate post-partum period.

    Do not forget that breastfeeding is nature’s way of providing birth control. The Lactational Amenorrhea Method is found to be 98.5 % effective as long as three conditions are met:

    1. Exclusive breastfeeding ( no formula, solids etc) and no prolonged periods (i.e. either day or night) without breastfeeding.
    2. Your menses have not returned.
    3. Your infant is less than 6 months old. 1

     

    1  Labbock et al  Multicenter Study of the Lactational Amenorrhea Method (LAM): 1. Efficacy, Duration, and Implications for Clinical Application. Contraception 1997;55:327-336

  3. I Am Having an MRI or CT Scan With Contrast, Can I Continue Breastfeeding?

    Yes, The American College of Radiology report notes the levels in breastmilk of iodinated and gadolinium based contrast material is very low immediately following the procedure (< 1%) with the contrast material being completely cleared within 24 hours. Based on the available data it is recommended that a mother can continue breastfeeding immediately following the procedure. Click here for the full statement.

  4. How Can I Protect Breastfeeding If My Infant or Myself Will Be Having a Medical Procedure?
    Please see our Breastfeeding and Medical Procedures article for details.