Medicines and breastfeeding

4-minute read

Most medicines are safe to take while breastfeeding because only a very small amount passes into breast milk and will not affect the baby.

Breastfeeding mothers rarely have to stop breastfeeding because they are taking medicines. However, it is important you get advice from your doctor or pharmacist. They will weigh up the risks and benefits of taking the medicine against any risks for your baby.

Before your doctor prescribes a medication for you, make sure he or she knows that you are breastfeeding.

Can medicines affect the baby?

Some medicines can give the baby diarrhoea or vomiting, or make them unusually sleepy or irritable. Other medicines can also cause you to have more or less milk production than normal.

The amount of medicine that enters the breast milk and the effect on the baby depend on the age and health of the baby, the type of medicine, how much you take, and when you take it.

You should take special care if your baby was premature, is sick, or is taking medicines themselves.

What medicines are dangerous to take during breastfeeding?

Sometimes mothers are advised to stop breastfeeding while they are taking some medicines in case they harm the baby. Examples of medicines that are not suitable while you are breastfeeding include:

some chemotherapy drugs for cancer
some drugs for heart conditions such as an irregular heart rhythm
lithium for some mental health conditions such as bipolar disorder
injectable medicines used during MRI scans
some medicines used to treat skin conditions such as acne or psoriasis

Do not assume that herbal medicines and teas are safe while you are breastfeeding. You should always talk to your doctor or midwife before you take a herbal medicine or tea.

What medicines can I take while breastfeeding?

Allergy and hay fever medicines: Antihistamines that do not make you sleepy are considered safe. Nasal sprays and eye drops are safe. Antihistamines that make you sleepy are not recommended because they may make your baby drowsy.

Antibiotics: Most antibiotics to fight infections are safe, but take your doctor's advice. Tetracyclines may be used short term. Metronidazole can make the milk taste bitter.

Antidepressants: Some antidepressants are safe. Discuss with your doctor.

Asthma medicines: Most preventers and relievers are safe. It is very important that you do not stop your asthma medicines while you are breastfeeding.

Cold and flu medicine: It is best to use steam inhalations, saline nasal sprays and decongestant nasal sprays. Avoid medicines containing pseudoephedrine.

Cough medicines: Coughs usually go away without treatment. If you do want to take cough mixture, ask your pharmacist which one is suitable. Avoid medicines containing pseudoephedrine.

Oral contraceptives (the pill): The progesterone-only 'minipill' is best. Combined oral contraceptive pills may affect your milk supply.

Painkillers: Ibuprofen and paracetamol are safe. Combined paracetamol and ibuprofen medication may not be safe while breastfeeding, discuss with your doctor. Avoid aspirin.

Worm treatments: Most worm treatments are safe.

Sore throat medicines: Lozenges and gargles are safe. Avoid medicines containing iodine.

How to minimise the risk

Sometimes it is best to express and discard your milk while you are taking medicine. This will keep up the milk supply.
Talk to your doctor or pharmacist about switching to a different medicine.
Take the medicine a different way, for example as a nasal spray.
Take the lowest possible dose to relieve your symptoms.
Take the medicine straight after a feed, or before your baby is due to have a long sleep.

Complementary and herbal medicines while breastfeeding

Complementary medicines include vitamins, herbal preparations, aromatherapy and homeopathic products. Like other medicines, complementary medicines can have side effects.

With most herbal and traditional medicines, there is not enough documented information to determine their safety in breastfeeding, so ask your health professional for advice.

What if I need a vaccination?

Most vaccinations are safe and effective while you are breastfeeding. However, yellow fever vaccination should be avoided unless it is absolutely necessary.

You can continue to breastfeed after you receive the flu (influenza) vaccine.