Medications and Breast Feeding

 

1.   What are the general rule for medications and breast feeding?

  • Most drugs are safe if they are commonly prescribed for infants
  • Most drugs are safe during breast feeding if they are considered safe during pregnancy
  • Drugs that are safe are not absorbed from the gastrointestinal tract e.g majority but not all drug that given through injections e.g heparin, local anaesthetics and inferon
  • Drugs that are safe are sometimes too big to be excreted into the breast milk e.g heparin, insulin, inferon
  • Medications applied to the skin or inhaled are generally safe
  • Consider that benefit and risk of taking the medication. If the benefit far outweigh the risk then it is perhaps better to continue the medication. Do consult your doctor prior to changing the dosage or ceasing your medications.
  • Normal x-rays and scan (CT or MRI). If the mother has to undergo this procedure it is generally safe for breast feeding. However, this is not true for radioactive thyroid scan. Ask your doctor for advice before doing the scan.

2. Which medications are safe during breast feeding?

Condition
Recommended agents
Alternative agents
Use with caution
Allergic rhinitis
Beclomethasone (Beconase)
Fluticasone (Flonase)
Cromolyn (Nasalcrom)
Cetirizine (Zyrtec)
Loratadine (Claritin)
Sedating antihistamines
Decongestants
Cardiovascular
Hydrochlorothiazide (Esidrix)
Metoprolol tartrate (Lopressor)
Propranolol (Inderal)
Labetalol (Normodyne)
Nifedipine (Procardia XL)
Verapamil (Calan SR)
Hydralazine (Apresoline)
Captopril (Capoten)
Enalapril (Vasotec)
Atenolol (Tenormin)
Nadolol (Corgard)
Sotalol (Betapace)
Diltiazem (Cardizem CD)
Depression
Sertraline (Zoloft)
Paroxetine (Paxil)
Nortriptyline (Pamelor)
Desipramine (Norpramin)
Fluoxetine (Prozac)
Diabetes
Insulin
Glyburide (Micronase)
Glipizide (Glucotrol)
Tolbutamide (Orinase)
Acarbose (Precose)
Metformin (Glucophage)
Thiazolinediones
Epilepsy
Phenytoin (Dilantin)
Carbamazepine (Tegretol)
Ethosuximide (Zarontin)
Valproic sodium (Depakote)
Phenobarbital
Pain
Ibuprofen (Motrin)
Morphine
Acetaminophen (Tylenol)
Naproxen (Naprosyn)
Meperidine (Demerol)
Asthma
Cromolyn (Intal)
Nedocromil (Tilade)
Fluticasone (Flovent)
Beclomethasone (Beclovent)
Contraception
Barrier methods
Progestin-only agents
Estrogen-containing contraceptives

3. Are there any specific website for checking specific information and certain drugs?

You could check out this website LactMed at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
REFERENCES
 
1.  Jack Newman. Handouts for Breast Feeding and medications. May 2008.
 
2. Jeanne P Spencer, Luis S Gonzalez. Medications in the Breast-Feeding
     Mother. American Family Physician July 1, 2001

 

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