Medications and Breastfeeding

After delivery, many women are relieved that they no longer have to worry that taking a pain reliever or cold pill may negatively affect the development of their growing fetus. Still, if you are breastfeeding and plan to take any kind of drug—whether prescription or over-the-counter—be sure to get the approval of your obstetric or pediatric health care provider.

Most medications are safe during breastfeeding, but a few can have serious side effects for your baby—and they are not necessarily the same ones that were most concerning during pregnancy. Your doctor is the best source of the most up-to-date information on which medications are safe for you at this time.

Much is still unknown regarding long-term effects of various kinds of medications. For this reason, it’s important to take medication only when absolutely necessary while breastfeeding, to use the safest drug, and to take the lowest dose possible. When possible, use short-acting drugs rather than longer-acting varieties. Short-acting drugs are best taken immediately after a nursing session, while sustained-release medications should be taken just after your baby’s last evening feeding or before his longest sleep period.

When taking any medication, watch closely for reactions in your baby, including loss of appetite, diarrhea, sleepiness, excessive crying, vomiting, or skin rashes. Call your baby’s pediatrician immediately if any of these symptoms appear. In the unlikely event that your doctor needs to prescribe a potentially harmful drug for a short time, you can express and store your milk ahead of time and then express and discard the milk with the drug until the medication is cleared from your body. The length of time required to clear the drug from your system varies based on the particular medication, but your doctor should advise you about this.

Birth Control

Frequent, exclusive breastfeeding (no water, juice, formula, solid foods, or other supplements for the baby), including at least one night feeding, significantly reduces the chance of your becoming pregnant during the first six months after birth. However, after about six weeks, especially if you are only partially breastfeeding, you can begin using contraceptives if your milk supply is firmly established. You should discuss the issue with your obstetrician or gynecologist. While there are no harmful effects on infants when mothers use hormonal contraceptives, research has shown that birth control pills with high doses of estrogen may decrease milk supply. Progestin-only pills (sometimes referred to as mini-pills) are least likely to interfere with breastfeeding, although they have increased side effects for the mother. Effects vary from woman to woman and with the type of pill, so discuss the possible ramifications with your doctor before you begin taking contraceptives. You might also consider using condoms, a diaphragm, or a cervical cap and spermicide instead, since these forms of birth control are least likely to interfere with your milk supply.

Homeopathic and Herbal Medicines

Many Americans are accustomed to turning to homeopathic remedies to treat routine illnesses, particularly when they are concerned about side effects associated with more mainstream medicines. However, just because a remedy is “natural” doesn’t mean it’s safe for breastfeeding women or their babies. In many cases, very little scientific research has been done regarding the implications of using such treatments while nursing.

In the United States, the Food and Drug Administration (FDA) does not regulate homeopathic, herbal, or natural remedies, meaning that the government does not oversee these products for purity or to make sure there are no toxic substances. When taken in large quantities, certain substances create negative effects such as increased blood pressure and reduced milk supply. It’s best to treat homeopathic remedies just as you would any medicine: Refrain from taking herbs or other homeopathic medications (aside from commercially produced herbal teas) unless your family physician, obstetrician, or pediatrician has approved them. Take approved substances in the smallest doses possible and carefully observe your baby for any negative reactions. Make sure your doctor and your baby’s pediatrician are aware of anything you are taking.