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Breastfeeding & Drugs

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

Alcohol/Ethanol
  • Alcoholic drinks
  • Regular use is harmful. Even occasional use can be a risk.
Tobacco smoke
  • Nicotine (active or passive smoking)
  • Nursing mothers should avoid smoking. May increase risk of sudden infant death syndrome (SIDS). May increase respiratory and ear infections.
Drugs of abuse
  • Cocaine and phencyclidine (PCP)
  • Amphetamines, heroin and marijuana
  • Can intoxicate the baby.
  • Can cause a variety of symptoms including irritability, poor sleeping patterns, tremors and vomiting. Babies can be addicted to these substances.

 

Last Reviewed : 23 April 2014
Writer : Che Pun bt. Bujang
Dr. Nour Hanah bt. Othman
Kamariah Shamsinar bt. Kamarul Baharin
Siti Nurul Fathihah bt. Baharudin
Hazlin bt. Othman
Reviewer : Atika Mahfuza bt. Mahbub