Medication and Substance Use During Breastfeeding

ByRavindu Gunatilake, MD, Valley Perinatal Services;
Avinash S. Patil, MD, University of Arizona College of Medicine
Reviewed/Revised Nov 2023
VIEW PROFESSIONAL VERSION

When women who are breastfeeding have to take a medication, they wonder whether they should stop breastfeeding. The answer depends on the following:

  • How much of the medication passes into the milk

  • Whether the medication is absorbed by the baby

  • How the medication affects the baby

  • How much milk the baby consumes, which depends on the baby's age and the amount of other foods and liquids in the baby's diet

When possible, medications should be taken immediately after breastfeeding or before the baby's longest period of sleep.

Medications That Are Relatively Safe During Breastfeeding

Medications that are applied to the skin, eyes, or nose or that are inhaled are usually safe.

Most antihypertensive medications do not cause significant problems in breastfed babies. Women may take beta-blockers during breastfeeding, but the baby should be checked regularly for possible side effects, such as a slow heart rate and low blood pressure.

and do not harm breastfed babies but may make them irritable. The baby's heart and breathing rates may increase.

Even though some medications are reportedly safe for breastfed babies, women who are breastfeeding should consult a health care professional before taking any medication, even an over-the-counter medication, or a medicinal herb. All medication labels should be checked to see whether they contain warnings against use during breastfeeding.

Did You Know...

  • Even though some medications are reportedly safe for breastfed babies, women who are breastfeeding should consult a health care professional before taking any medication, even an over-the-counter medication, or a medicinal herb.

Medications That Require a Doctor’s Supervision During Breastfeeding

Some medications require a doctor’s supervision during their use. Taking them safely while breastfeeding may require the following:

  • Adjusting the dose

  • Limiting the length of time the medication is used

  • Timing when the medication is taken in relation to breastfeeding

Most antianxiety medications, antidepressants, and antipsychotic medications

(a medication that prevents blood from clotting) can be taken if the baby is full-term and healthy. Warfarin does not appear to enter breast milk. People who take warfarin, including women who are breastfeeding, need to have blood tests done periodically to determine whether blood is clotting normally. Warfarin can cause a tendency to bruise or bleed.

Medications and Substances That Should Not Be Taken While Breastfeeding

Some medications and other substances should not be taken by mothers who are breastfeeding. They include

Medications that may suppress milk production include estrogen, oral contraceptives that contain high-dose estrogen).

If women who are breastfeeding must take a drug that may harm the baby, they must stop breastfeeding. But they can resume breastfeeding after they stop taking the drug. While taking the drug, women can maintain their milk supply by pumping breast milk, which is then discarded.

Women who are breastfeeding should consult their health care professional about all the drugs they are taking or about to start.

Women who smoke should not breastfeed within 2 hours of smoking and should never smoke in the presence of their baby whether they are breastfeeding or not. Smoking reduces milk production and interferes with normal weight gain in the baby.

Alcohol consumed in large amounts can make the baby drowsy and cause profuse sweating. The baby's length may not increase normally, and the baby may gain excess weight. Drinking up to 1 standard drink per day does not appear to harm the breastfeeding infant, especially if a woman waits at least 2 hours after a single drink before breastfeeding.

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