It’s understood that all medications can diffuse into breastmilk¹, but many times there is a point of ignorance and anxiety from healthcare providers on knowing which medications infiltrate to a dosage that’s measurable or harmful to the breastfeeding infant/child. This leads to unnecessary cessation, or halt, of breastfeeding and pumping. Many over-the-counter (OTC) and prescription (Rx) medications are actually fine to take while continuing to provide breastmilk. For the medications that are contraindicated, there is almost always an alternative.²
Over-the-Counter Medications and Breastfeeding
Things to consider before taking a medication would be the ingredients, number of ingredients, age and health of the baby, half-life or duration of medication lasting in the system, effects on milk supply, timing of dose administered, necessity and urgency for taking the medication(s), and needs for possible temporary weaning³, the last being more in line with a prescription medication as opposed to an over-the-counter medication.
In mature milk, as in, no longer in colostrum stage and well-established, the alveoli storing the milk actually act as a physical barrier to items that do not belong in the milk. This means the chemicals of a medication that are able to seep through are in minuscule amounts and unlikely to cause an issue in the baby with such a small dosage. This may not pose true in cases of prematurity or fragile conditions. However, if the medication is something safe for the infant to take directly, it is even safer in the diluted form from breastmilk absorption.
Another consideration, on the err of caution, are the number of ingredients in the medicine and if combined with other medications. Some may be advised to take their dosage at the immediate end of a feeding to lessen the amount in the milk and allow the body to metabolize it before the next feeding, much like the advice given for alcohol consumption. It is also important to take into account any other medicines and supplements that may interfere, along with discussing these topics with the primary care physician.
The main issue that will present when taking an OTC medication is the effect on the actual milk supply. Many medications for cold and allergy relief contain pseudoephedrine and similar compounds that are designed to dry up secretions. This does not individually select just mucous secretions, but also saliva causing dry mouth, and more importantly, milk secretions. Trying alternative comfort measures is recommended in times of cold and allergy symptoms such as steam, eucalyptus, anti inflammatory foods such as garlic and turmeric.
While obtaining accurate information on medicinal effects in breastfeeding situations is quite difficult due to ethical boundaries, there are wonderful resources with ever-updating information on what is known, back by evidence-based research. LactMed is a free tool from the National Institute of Health that allows searches for both OTC and Rx medications to check on the indications of taking while breastfeeding, along with providing possible alternatives if the one in question is contraindicated. Having this reliable information handy will help navigate options, as well as aid in any discussions with the doctor.
1. Thomas Hale, RPh, PhD (Medications and Mothers’ Milk 2014, p. 7-12) Breastfeeding and Medication, American Academy of Pediatrics, https://www.aap.org/en-us/Pages/Breastfeeding-and-Medication.aspx
2. LactMed: A TOXNET DATABASE, National Institute of Health (NIH), https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
3. “How do I determine if a medication is safe for a breastfeeding mother?” Kelly Mom Parenting and Breastfeeding, https://kellymom.com/hot-topics/med-risks/
All content published on the Motif Medical site is credited for information purposes only. This information should not substitute as medical advice, diagnosis, or treatment. Always consult your doctor or qualified health professional with any questions regarding the health of you or your baby.
About the Author
Ashley is an International Board Certified Lactation Consultant (IBCLC) that specializes in the clinical management of breastfeeding and an expert in the field of lactation. Ashley is from Knoxville, TN, and is a mother who has dealt with the obstacles and joys of breastfeeding. As the owner of Genesis Lactation, she educates families, connects them to resources, and helps the next generation be as healthy as possible: nutritionally and sustainably