Breastfeeding mothers often face the challenge of balancing their own health needs with the safety of their infants. This comprehensive guide addresses the safety of the 20 most commonly used medications during lactation, providing crucial information for nursing mothers and healthcare providers alike.
Medication Safety While Breastfeeding:
Before diving into specific medications, it’s important to understand that most drugs transfer into breast milk to some extent. However, the amount is usually small and often doesn’t pose a risk to the infant. Always consult with a healthcare provider before starting or stopping any medication while breastfeeding.
List of 20 Common Medications and Their Safety Ratings:
1. Ibuprofen (Advil, Motrin)
Safety Rating: L1 (Safest)
Effects: Minimal transfer to breast milk, no reported adverse effects on infants
Alternatives: Acetaminophen
2. Acetaminophen (Tylenol)
Safety Rating: L1 (Safest)
Effects: Minimal transfer to breast milk, considered safe for infants
Alternatives: Ibuprofen
3. Levothyroxine (Synthroid)
Safety Rating: L1 (Safest)
Effects: Essential for maternal health, no adverse effects on infants
Alternatives: Not applicable, required for thyroid function
4. Sertraline (Zoloft)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, generally considered safe
Alternatives: Consult healthcare provider for other antidepressant options
5. Amoxicillin
Safety Rating: L1 (Safest)
Effects: Minimal risk to infants, may cause temporary changes in bowel flora
Alternatives: Depends on the type of infection, consult healthcare provider
6. Omeprazole (Prilosec)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, no reported adverse effects on infants
Alternatives: Famotidine, lifestyle changes
7. Loratadine (Claritin)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, considered safe for infants
Alternatives: Cetirizine, nasal saline sprays
8. Fluoxetine (Prozac)
Safety Rating: L2 (Safer)
Effects: Transfers to breast milk, monitor infant for drowsiness or irritability
Alternatives: Sertraline, consult healthcare provider
9. Metformin
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, no reported adverse effects on infants
Alternatives: Insulin, lifestyle changes
10. Escitalopram (Lexapro)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, generally considered safe
Alternatives: Sertraline, consult healthcare provider
11. Cetirizine (Zyrtec)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, considered safe for infants
Alternatives: Loratadine, nasal saline sprays
12. Metoprolol
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, monitor infant for drowsiness or low blood sugar
Alternatives: Labetalol, consult healthcare provider
13. Prednisone
Safety Rating: L2 (Safer)
Effects: Transfers to breast milk, use lowest effective dose, time doses with feedings
Alternatives: Depends on condition, consult healthcare provider
14. Citalopram (Celexa)
Safety Rating: L2 (Safer)
Effects: Transfers to breast milk, monitor infant for drowsiness or irritability
Alternatives: Sertraline, consult healthcare provider
15. Montelukast (Singulair)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, no reported adverse effects on infants
Alternatives: Inhaled corticosteroids, consult healthcare provider
16. Albuterol (Ventolin)
Safety Rating: L2 (Safer)
Effects: Minimal systemic absorption, considered safe for infants
Alternatives: Not applicable for acute asthma symptoms
17. Metronidazole
Safety Rating: L2 (Safer)
Effects: Transfers to breast milk, consider pumping and discarding milk for 12-24 hours after last dose
Alternatives: Depends on type of infection, consult healthcare provider
18. Hydrocodone
Safety Rating: L3 (Moderately Safe)
Effects: Transfers to breast milk, monitor infant for drowsiness, use lowest effective dose
Alternatives: Acetaminophen, ibuprofen, non-pharmacological pain management
19. Ondansetron (Zofran)
Safety Rating: L2 (Safer)
Effects: Minimal transfer to breast milk, no reported adverse effects on infants
Alternatives: Ginger, vitamin B6, consult healthcare provider
20. Lisinopril
Safety Rating: L3 (Moderately Safe)
Effects: Transfers to breast milk, potential risk to infant, monitor blood pressure
Alternatives: Labetalol, nifedipine, consult healthcare provider
Potential Effects on Milk Supply and Infant:
While most of these medications are considered safe, always monitor your infant for any changes in feeding patterns, sleep habits, or behavior. Some medications may affect milk supply, particularly those containing pseudoephedrine or high doses of hormonal contraceptives.
Alternatives for Unsafe Medications:
If a medication is deemed unsafe, consult your healthcare provider for alternatives. Often, there are safer options within the same drug class or non-pharmacological treatments that can be effective.
When to Consult a Healthcare Provider:
Always consult your healthcare provider or a lactation specialist before starting, stopping, or changing any medication while breastfeeding. Seek immediate medical attention if you notice any unusual symptoms in your infant after taking a medication.
While this guide provides a general overview, individual factors such as infant age, maternal health, and specific medication dosages can affect safety. Always prioritize professional medical advice for your unique situation.