Weigh The Risks

When considering the risks of taking a particular medication while breastfeeding, it's important to understand the nature of these risks, along with the risks of weaning.

• A physician will recommend weaning when uncertain about the effects of a drug in human milk. The when in doubt leave it out policy is common among healthcare providers, since it's impossible to keep up with all the research on the safety of drugs while breastfeeding. Yet this approach assumes that there are no risks involved in weaning to formula. While many physicians, like the general public, make this assumption, it is not true. The risks of exposing a baby to a drug in breastmilk should be weighed against the known risks of exposing a baby to infant formula while depriving him of breastmilk. Remember that all the advantages of breastfeeding (see Breastfeeding Benefits from Top to Bottom and Comparison of human milk and infant formula) can be turned around and understood as risks of formula feeding.
• Be aware that often what a mother is told about taking a medication about breastfeeding is based more on legal considerations than scientific knowledge. The information available from pharmaceutical companies about a drug, either in package inserts or in The Physician's Desk Reference (the PDR), often advises mothers not to breastfeed while taking a drug, but this advice reflects the company's desire to protect itself from lawsuits and to avoid having to do expensive research that would allow it to say a certain drug is safe. Healthcare providers advising nursing mothers should rely on additional sources of information that are more accurate and breastfeeding-friendly. This would prevent babies from being weaned unnecessarily.

Once you and your doctor have weighed the alternatives and together made the decision that it is in the best interests of you and your baby to take the medicine, be sure you understand the dosage, the timing, the possible adverse effects on you (e.g., stomach ache, headache, diarrhea), and if there are any possible adverse effects to watch for in your baby.

When you pick up the medicine at the pharmacy, check the label and be sure it agrees with what your doctor told you. Keep in mind that doctors oftentimes do not discuss possible adverse drug reactions with patients for two reasons: they occur in a small minority of patients, and if you expect certain reactions, you are more likely to experience them, or imagine you do.