Most medications have not been tested in nursing women, so
no one knows exactly how a given drug will affect a breast-fed child.
Since very few problems have been reported, however, most
over-the-counter and prescription drugs, taken in moderation and only
when necessary, are considered safe.
Even mothers who must take daily medication for conditions such as
epilepsy, diabetes, or high blood pressure can usually breast-feed.
They should first check with the child's pediatrician, however. To
minimize the baby's exposure, the mother can take the drug just after
nursing or before the child sleeps. In the January 1994 issue of
Pediatrics, the American Academy of Pediatrics included the following
in a list of drugs that are usually compatible with breast-feeding:
- acetaminophen
- many antibiotics
- antiepileptics (although one, Primidone, should be given with
caution)
- most antihistamines
- alcohol in moderation (large amounts of alcohol can cause
drowsiness, weakness, and abnormal weight gain in an infant)
- most antihypertensives
- aspirin (should be used with caution)
- caffeine (moderate amounts in drinks or food)
- codeine
- decongestants
- ibuprofen
- insulin
- quinine
- thyroid medications
Some drugs can be taken by a nursing mother if she stops
breast-feeding for a few days or weeks. She can pump her milk and
discard it during this time to keep up her supply, while the baby
drinks previously frozen milk or formula.
Radioactive drugs used for some diagnostic tests like Gallium-69,
Iodine-125, Iodine-131, or Technetium-99m can be taken if the woman
stops nursing temporarily.
Drugs that should never be taken while breast-feeding include:
Bromocriptine (Parlodel): A drug for Parkinson's
disease, it also decreases a woman's milk supply.
Most Chemotherapy Drugs for Cancer: Since they kill cells in
the mother's body, they may harm the baby as well.
Ergotamine (for migraine headaches): Causes vomiting,
diarrhea, convulsions in infants.
Lithium (for manic-depressive illness): Excreted in human
milk.
Methotrexate (for arthritis): Can suppress the baby's immune
system.
Drugs of Abuse: Some drugs, such as cocaine and PCP, can
intoxicate the baby. Others, such as amphetamines, heroin and
marijuana, can cause a variety of symptoms, including irritability,
poor sleeping patterns, tremors, and vomiting. Babies become addicted
to these drugs.
Tobacco Smoke: Nursing mothers should avoid smoking. Nicotine
can cause vomiting, diarrhea and restlessness for the baby, as well as
decreased milk production for the mother. Maternal smoking or passive
smoke may increase the risk of sudden infant death syndrome (SIDS) and
may increase respiratory and ear infections.
From the FDA's Web site http://www.fda.gov
This material originally appeared in the Oct. 1995 edition of the
FDA Consumer magazine
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