One of the most commonly searched questions about breastfeeding is, “What medicines can you take?” Since everything you consume makes its way into your baby’s milk supply, it’s a valid concern. Sure, we know to pump and dump after a couple glasses of wine, but what about medications?
There are myriad benefits to breastfeeding your baby. Nursing reduces a woman and her baby’s risk of getting breast cancer, and the antibodies in human milk protect against infection and build the immune system. While there are many benefits, it’s also important that breastfeeding moms take care of their own health. Sometimes, that means taking medication. Certified Lactation Education Counselor and Certified Childbirth Educator AAHCC Liza Janda breaks down what’s OK and what’s off limits.
What to do before taking any medications
“The most important thing a lactation educator consultant can do is educate the mother on being an active participant in her health care decisions,” Janda says. “Most medications are suitable to take while breastfeeding. Many mothers are told they need to stop breastfeeding to take a medication or do a test or a procedure. In most cases, this is unnecessary.”
Janda recommends asking yourself and your physician important questions before taking any medications:
• Are there alternatives to treatment that don’t involve medication?
• Is there an alternative medication that may be safer?
• Do the benefits of taking the medication outweigh the risks to my baby?
In the clear
With all medications during breastfeeding, there is a risk that trace amounts will end up in your milk supply. In most cases, however, the amount is very small and will not harm your child.
Ibuprofen is generally safe for nursing women to take. A 1984 study found that moms who took 400mg of ibuprofen every six hours passed on less than 1mg to their supply, an amount that will not negatively affect your baby, but nursing women should not take more than the daily maximum dose. Of course, consult your doctor before taking.
In the way of painkillers, acetaminophen and naproxen are also OK for breastfeeding mothers. However, naproxen (Aleve, Midol, Flanax) should be used for the short-term only.
According to Planned Parenthood, it is safe to use hormonal methods of birth control while breastfeeding. These include the shot, implant, Skyla and Mirena IUDs, and some kinds of birth control pills (known as the minipill). However, methods that include the hormone estrogen (pills, patch, or ring) should be avoided for the first three weeks after giving birth. After three weeks, these hormonal methods are fair game once again.
If you have symptoms of a cold, that’s where medication while breastfeeding gets tricky.
“Cold medicine can affect milk supply,” Janda says. “If the goal of the cold remedy is to dry up a stuffy nose, it will probably also lower her milk supply.”
Most decongestants like Sudafed and Zyrtec D contain pseudoephedrine, which can lower milk supply. Use medications with this ingredient with caution. For a full list on what medications are safe to take while breastfeeding, check out this guide from the Mayo Clinic.
Not so safe
Contraindicated is a medical term that means a procedure or medication is unadvisable. While breastfeeding, contraindicated drugs include anticancer drugs, lithium, oral retinoids, iodine, amiodarone, gold salts, marijuana and other recreational drugs.
If you’re interested in researching a particular medication, there’s ToxNet. ToxNet’s LactMed feature is a resource and database featuring 31 antibiotics, their safety, and the amount that shows up in breast milk. You can also search SSRIs and other meds.
Drinking, smoking, and using CBD while breastfeeding
“Breastfeeding mothers can drink alcohol, but it takes 2-3 hours to metabolize one 5-ounce glass of wine, 1-2 ounces of hard liquor, and one 8-ounce of beer,” Janda explains. “Do not breastfeed for 2-3 hours after that one serving. If she drinks more than one serving, it will take 4-6 hours to metabolize.”
Smoking nicotine is recognized as off-limits for nursing mothers, as nicotine in the milk supply can cause fussiness, diarrhea, vomiting, rapid heard beat and restlessness in infants, according to Janda.
As for CBD, the jury’s still out. “There’s not enough research or regulation to decide about CBD,” Janda says. “So, just avoid it to be safe.”