Deal Breastfeeding Support Group

Drugs and Breast milk

Over the years, many women have been wrongly told that they had to stop breastfeeding because of various drugs or medications they were prescribed. There are many reasons for this.

Many doctors are afraid to prescribe a drug because of the conservative approach taken towards giving drugs to pregnant women; they feel that if a drug could possibly cause birth defects in a pregnant woman, they shouldn't give it to a lactating woman. Some doctors are hesitant to prescribe any medications for a mother who is breastfeeding, once they learn that even a tiny amount will enter the mother's milk.

Some doctors rely on biased sources of information. Many use the BNF as a source of information on various medications and their effects on breastfeeding. The information in this publication is provided by pharmaceutical companies and is often overcautious because of company fears of possible litigation. For example, it is difficult for ethical reasons to do drug research on breastfeeding mothers and babies, but if that research has not been done, the BNF will frequently state that a medication is not compatible with breastfeeding. This is true even if that same drug is commonly prescribed in very much larger doses for newborn babies (Most ingested drugs that appear in the milk do not exceed 1% of the ingested dose, and many do not actually pass into the breast milk at all.) N.B Almost no medicine given as eye-drops or skin cream gets into your milk.

Many doctors will recommend that no drug should be taken by a breastfeeding mother unless it has been proven absolutely safe in all circumstances

The problem with that is that there is virtually no drug that can be said to be absolutely safe all the time.  Since very few problems have actually been reported, however, most over-the-counter and prescription drugs are considered safe in most situations, and very few drugs are contraindicated for nursing mothers (For those few that aren’t, there is almost always an alternative).

So then, how do we know whether to be concerned about a medication being prescribed for a breastfeeding mother?  There are two basic questions the mother and doctor need to ask:
1. Is the medication transferred into breast milk?
2. If the medication gets into breast milk, what is the effect on the infant?

Written by R. White (Midwife)

Medications and Mothers Milk: A Manual of Lactational Pharmacology by  Thomas W., Ph.D. Hale Pharmasoft Medical Pub; 13 edition (Jul 2008)

For further information about drugs and breastmilk, see links above