I’m sorry you’re sick, mommy,” said no baby ever. So what happens when a nursing parent needs an antibiotic, some cough syrup, or something to fend off that fever? And what about medications that need to be taken daily, like antidepressants or allergy meds?
If there’s one thing parents are good at, it’s putting their kiddos first. The good news is that in most cases, you don’t have to choose between what’s best for your own health and nursing your baby. You just need the right information and some good support.
Did You Take the Medication in Pregnancy?
A good rule of thumb is that if you took the medication in question while you were pregnant, you can probably continue taking it when nursing. During pregnancy, medications you take go directly into baby’s bloodstream via the placenta. Post-birth, during nursing, baby gets any medications you’re taking in your milk. This means baby digests those medications, so they’re typically absorbed at a far lower concentration. The only exception to this rule is when the medication might impact your milk supply, which brings us to the next question…
Will Medications Affect My Milk Supply?
Some medications, such as antihistamines (Benadryl, Zyrtec, etc.) and decongestants (Sudafed, Claritin D, etc.) can reduce your milk supply. Birth control with estrogen, and fertility medications like Clomid can also decrease your milk supply.
What Medications are Usually Fine?
According to the American Academy of Pediatrics, most medications and immunizations are safe during lactation. Not only are most vaccines considered safe (including COVID-19) but getting vaccinated allows you to pass antibodies to your baby while nursing.
Most medications used to treat postpartum depression and anxiety, asthma, high blood pressure, diabetes, thyroid dysfunction, and infection (including most antibiotics) are usually fine for nursing parents. General and local anesthesia are also safe. Progestin-only birth control methods are OK as long as they’re started after the first four weeks postpartum. Pain and fever reducers like acetaminophen (Tylenol) and ibuprofen (Advil or Motrin) are safe, as are cough medicines like guaifenesin (Robitussin) and dextromethorphan (Robitussin DM). If you’re not sure, look it up online at MommyMeds for Mothers, LactMed, or Infant Risk Center, or run it by your baby’s pediatric provider first.
Should I Pump and Dump to Be Safe?
If you’re not sure if it’s safe to continue nursing while taking that medication, it might seem like a simple answer to switch to bottle feeding (either formula or previously stored milk), and pump so your milk doesn’t dry up. But before you pull out that pump, consider the risks, benefits, and alternatives of that decision.
This decision may affect your baby’s latch and your nursing relationship. In addition, some people find that their bodies don’t respond as easily to the pump as they do to their baby, and this breastfeeding interruption can reduce milk production.
Formula Feeding
Some switch to formula “just to be safe” when they don’t know where to find the answers they need about a specific medication. Formula fed babies are more prone to infections in the first year of life because baby isn’t getting the protective antibodies in mom’s breastmilk. Those infections include ear, respiratory, and gastrointestinal infections in babies who are supplemented with formula during their first six months.
Is this Medication Risky?
The risk of a particular medication will vary including how easily the medication passes from your bloodstream into your breastmilk, how well it’s absorbed in baby’s digestive tract, and baby’s age (and how mature their liver is).
What Medications Are Too Risky During Nursing?
Certain life-saving therapies, such as chemotherapy and radiation therapy are absolutely prohibited in breastfeeding/chestfeeding. While human milk is excellent for babies’ health, it’s even more important for mom to be alive!
Certain illicit and recreational drugs are also considered unsafe, if you’re in a supervised methadone treatment program you’ll be encouraged to continue nursing. Smallpox and yellow fever are the only two vaccines not considered safe during nursing.
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