The tables on this page list medications in three categories:
- Common medications that are safe to use while breastfeeding
- Drugs that require careful monitoring by a physician when taken while breastfeeding
- Drugs that should not be used while breastfeeding.
Talking with your health professional about any medication you take is very important, and a nursing mother should always remind her physician that she is breastfeeding when decisions are being made about medications.
If you need additional information about a medication, or if you need information about a medication not listed in these tables, please consult additional sources of information.
Common medications that are safe to use while breastfeeding
The safety of the following medications is established for short-term use only. If you are required to take one of these for more than one or two weeks, consult a physician.
| acetaminophen | asthma medications (cromolyn, inhalant bronchodilators) | Kaopectate |
| acyclovir | barium | laxatives |
| anesthetics local (e.g., dental work) | chloroquine (antimalarial) | muscle relaxants |
| antacids | cortisone | pinworm medications |
| antibiotics (tetracycline* and sulfa**) | decongestants | propranolol |
| anticoagulants | digitalis | propylthiouracil |
| anticonvulsants | diuretics | silicone from implants |
| antihistamines | ibuprofen | thyroid medications |
| aspartame | insulin | vaccines |
| vitamins | ||
| * Avoid taking tetracycline for longer than ten days ** Avoid in newborn period | ||
Drugs that require careful monitoring by a physician when taken while breastfeeding
Whether these drugs and medications are safe to take while breastfeeding depends on many factors: the dosage, age of infant, duration of therapy, and timing of dosage and breastfeeding. Consult a physician knowledgeable about drugs during breastfeeding if you need to take any of the following medications long-term.
| alcohol | general anesthetics* | morphine |
| antidepressants | indomethacin | oral contraceptives |
| aspirin | isoniazid | Paxil |
| codeine | lithium** | phenobarbitol |
| Demerol | metoclopramide | Prozac |
| ergots | metronidazole (Flagyl)*** | Valium |
| Zoloft | ||
| * It is safe to breastfeed six to twelve hours after most general anesthetics. ** Some authorities consider lithium absolutely contraindicated while breastfeeding; others believe lithium can be used cautiously, as long as blood lithium concentration in the baby is monitored. *** Authorities recommend giving the mother a single two-gram dose and having her discontinue breastfeeding for only twelve to twenty-four hours. | ||
Drugs that should not be used while breastfeeding
| amphetamines | heroin | Mysoline |
| antimetabolite drugs (anti-cancer drugs) | Lindane | nicotine |
| cocaine | marijuana | Parlodel |
| cyclosporine | methotrexate | PCP |
| radioactive drugs for diagnostic tests* | ||
| * May need to stop breastfeeding temporarily. Consult a nuclear medicine specialist. | ||
If you need more information about taking a specific medication during breastfeeding, consult the following sources. Or ask your doctor to find out more about the drug using these references.
American Academy of Pediatrics Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics 1994; 93:137-50. Reprinted in The Breastfeeding Answer Book, rev. ed. by N. Mohrbacher and J. Stock. Schaumburg, IL: La Leche League International, 1997, 525- 538. (Most La Leche League Leaders have access to this book and will read the information about a specific drug to you over the phone.)
Briggs, G., Freeman, R., and Yaffe, S. Drugs in Pregnancy and Lactation, 4th ed. Baltimore: Williams and Wilkings, 1994.
Hale, T. Medications and Mother’s Milk, 7th ed. Amarillo, TX: Pharmasoft, 1998-99. (Order from LLLI, or see Dr. Hale’s website at http://www.halepublishing.com)
Lawrence, R. Breastfeeding: A Guide for the Medical Profession, 5th ed. St. Louis: Mosby, 1999.
US Pharmacopeial Convention. United States Pharmacoepia Dispensing Information: Drug Information for the Health Care Professional, 16th ed. Rockville, Maryland: US Pharmacopeial Convention, 1996.