When you are breastfeeding, you might wonder if the medicines you take could affect your baby. Whether you need medicine for a headache, allergies, a cold or a health condition, you may worry about what is safe while nursing.
The good news is that many medicines are safe to use while breastfeeding. But every mother, baby and medication is different. The type of medicine, the dose, how often you take it and your baby’s age and health can all play a role.
We spoke with Shelbie Radom, MSN, RN, IBCLC, a lactation consultant and prenatal educator at Banner Health. She explained which medicines are generally safe, which ones you should ask about and what questions to ask your doctor.
How do medicines pass into breast milk?
Almost all medication you take can end up in your breast milk in some amount. Your body makes breast milk, so if a medicine gets into your blood some of it will pass into the milk.
“Your breasts have tiny milk-making cells shaped like grapes, called alveoli,” Radom said. “These cells take nutrients from your blood to make milk. They also act like filters, which is why most medicines pass through in very small amounts.”
But just because a medicine gets into breast milk doesn’t mean it’s harmful. It depends on how much medicine reaches your baby and how your baby’s body absorbs it.
How do I know if a medication is safe to take while breastfeeding?
Most medicines are safe to take or considered “low risk” while breastfeeding. Still, a few medicines aren’t safe to take while breastfeeding. It’s important to talk to your health care provider about each medicine and supplement you take so they can help guide you.
When experts evaluate a medication, Radom said they consider the following:
- How much of the drug reaches the milk: Usually, this is only a tiny part of the dose you take.
- Your baby’s age and health: Newborns and premature babies process medicines more slowly than older babies.
- How much your baby absorbs: Some medicines don’t easily pass through your baby’s gut.
- The type of medication: Some medicines are safer than others based on how they are made.
Should I stop breastfeeding if I am taking medicine?
Not necessarily. If you’re taking a medication that could harm your baby, your health care provider might suggest an alternative or adjust the timing of your doses.
Many people need medication for chronic health conditions while breastfeeding. These may include high blood pressure, diabetes, asthma, depression or anxiety and thyroid disorders.
In many cases, continuing treatment is important for your health and your baby’s well-being. Your provider can help choose medications that are generally considered compatible with breastfeeding.
Common medications considered safe while breastfeeding
Many commonly used medications are considered low risk for breastfeeding parents. Always read the labels and confirm with your provider before starting something new.
- Acetaminophen (Tylenol): Commonly used for pain and fever. It passes into breast milk in very low amounts.
- Ibuprofen (Advil, Motrin): Low levels reach breast milk and it has a long safety record. Talk with your pain management provider if you need stronger relief.
- Non-drowsy antihistamines: Loratadine (Claritin) and cetirizine (Zyrtec) are usually the best options if you are unable to control allergy symptoms with other treatments such as saline rinses or saline spray. Older antihistamines, such as diphenhydramine (Benadryl), can sometimes reduce milk supply.
- Many antibiotics: Amoxicillin, azithromycin and cephalexin are commonly used during breastfeeding. Your baby may have looser stools for a few days but this usually passes.
- Topical medications: Creams, ointments and topical steroids are generally safe because very little is absorbed into the bloodstream. Avoid applying them to or near the nipple unless your provider says it’s okay.
- Some short-term decongestants: Saline sprays and short courses of certain decongestants may be fine but watch for changes in milk supply.
- Antacids and famotidine (Pepcid): These work well and don’t cause problems for your baby.
- Some antidepressants: Many are compatible with breastfeeding but the right choice varies by type and dose.
- Vaccines: Almost all vaccines, including the flu and COVID-19 shots, are safe during breastfeeding. They may even pass helpful antibodies to your child. A few live vaccines have timing considerations, so ask your provider.
Medications that may require caution or timing
Some medications may require closer review, timing adjustments or alternatives. Talk with your provider before taking them.
- Sleep aids and sedatives
- Opioid pain medications (codeine, tramadol and others)
- Some antihistamines
- Certain antidepressants
- Some decongestants containing pseudoephedrine
- Certain acne treatments
- Some migraine medications
- Some medications for cancer treatment or seizures
- Certain hormonal birth control containing estrogen
Are herbal supplements safe to take while breastfeeding?
Not always. Many people think herbal supplements are safe because they’re labeled “natural.” But natural products can still affect you and your baby.
Many herbal products:
- Have not been well studied in breastfeeding parents
- Can vary in strength and purity
- Pass into breast milk just like medications
- May interact with other medications
“For example, fenugreek, an herb sometimes used to increase milk supply, has been known to cause digestive issues in the breastfeeding parent and the baby,” Radom said. “Herbal supplements may also increase or decrease milk production in unexpected ways.”
Before using any herbal product, check with your provider or lactation consultant.
What about medications for ongoing health conditions?
If you take medication for a chronic condition, please don’t stop on your own. For most ongoing conditions, continuing treatment is important for your health and protects your baby, too.
Common conditions and considerations:
- High blood pressure: Several blood pressure medications are compatible with breastfeeding.
- Thyroid disorders: Levothyroxine and most thyroid medications are considered safe.
- Diabetes: Insulin and many oral diabetes medications are compatible with breastfeeding. Breastfeeding can also help with blood sugar control.
- Asthma: Inhalers, including most rescue and controller inhalers, are generally considered safe.
- Depression and anxiety: Treating postpartum mood symptoms is one of the best things you can do for yourself and your baby. Many antidepressants, including sertraline (Zoloft), have strong safety records during breastfeeding.
Your health care provider can help you choose options that protect both your health and your milk supply. Together, you can pick the best path forward.
Questions to ask your provider or pharmacist
Instead of guessing, ask the following questions before taking any medication or supplement:
- Is this medication generally considered safe while breastfeeding?
- Will it affect my milk supply?
- What side effects should I watch for in my baby?
- When should I take it?
- Is there a safer alternative?
When to call your health care provider
If you think your baby is reacting to a medication you’re taking while breastfeeding, it’s important to stay calm. Most medication-related reactions are mild and temporary. In rare cases, symptoms can be a medical emergency.
Call your pediatric provider or lactation expert if your baby has:
- Fussiness or irritability
- Poor feeding or changes in latch (suck)
- Vomiting or diarrhea
- Rash or hives
Call 911 if your baby has:
- Increased sleepiness or difficulty waking
- Any change in color or difficulty breathing
- Persistent vomiting or diarrhea
- A spreading rash
- Any signs of dehydration
If you have ongoing concerns, a lactation consultant can help. For other nursing questions, our common breastfeeding challenges is a helpful next read.
Bottom line
Many medications are compatible with breastfeeding, but safety depends on the specific drug and your situation. Most pass into milk in very small amounts and many common medicines are considered low risk. Always check with your health care provider before starting or stopping medication.
If you have questions about medications while breastfeeding, talk with a Banner Health specialist.
Frequently asked questions
Can I take pain relievers while breastfeeding?
Acetaminophen and ibuprofen are generally considered safe but confirm with your health care provider.
Can breastfeeding moms take antibiotics?
Many antibiotics are compatible but some require caution depending on the type. Your provider can choose a safe option.
Are herbal supplements safe while breastfeeding?
Not always. Many are not well studied and should be discussed with your provider first.
What should I do if my baby reacts to a medication?
Contact your health care provider right away if you notice fussiness or changes in feeding. Call 911 if you notice severe symptoms.
Do I need to “pump and dump” after taking medications?
Almost never. Pumping and dumping doesn’t speed up how fast medication leaves your body.
Should I stop breastfeeding to take a medication?
Usually no. Avoid abruptly weaning unless you are advised to do so by a provider. This can create more stress for you and the baby.
Do the same rules apply for medications when I’m pregnant?
Medication safety during breastfeeding is different from medication safety during pregnancy. A drug that wasn’t recommended while you were pregnant may be safe now. Talk to your health care provider for pregnancy-safe choices and see our guide to cold and flu symptom relief for pregnant women.
