Medications and substance use while breastfeeding
Most common prescription and over-the-counter medications are relatively safe for use during breastfeeding. (See: Drugs and breastfeeding)
There is often inconsistent advice provided to mothers about the safety of continuing to breastfeed when taking medications. The amount of medication passed through to breastmilk is very small and well below the known safe doses given directly to babies. The effect medication has on the baby depends on factors including timing of the dose, volume of breastmilk taken by the baby, fat content of the breastmilk, and the age of the baby.
Some medications can also decrease milk supply or may cause drowsiness in mother and baby.
If unsure about a medication taken by a breastfeeding mother, health professionals can refer to the National Prescribing Service, the Drugs and Lactation Database (LactMed) or a relevant healthcare professional (e.g. general practitioner or pharmacist). They should let them know they are breastfeeding before they take any medicine.
Given the benefits of breastfeeding for baby, mother and society, breastfeeding should only be discontinued if there is evidence that a drug or medication taken by the mother will cause harm to the baby. In some cases, there may also be other medications or treatment options available to allow the mother to continue to breastfeed:
- Ensure the mother has told their doctor or pharmacist that they are breastfeeding.
- Feeding the baby just before taking medications will result in the lowest possible concentration in breastmilk for most medications.
Prescription medications and breastfeeding
- Any prescription medications taken by a breastfeeding mother may pass into the milk.
- Medications are given a 'safety' rating for breastfeeding.
- Most medications prescribed by a health professional do not need to be avoided.
Over-the-counter medications and breastfeeding
- Any over-the-counter medications taken by a breastfeeding mother may pass into the milk.
- Paracetamol, when taken as directed, is safe for breastfeeding.
- Breastfeeding mothers should avoid any cold or flu tablets containing pseudoephedrine and phenylephrine. These can make the baby unsettled. Pseudoephedrine has been known to decrease milk supply.
Complementary and alternative medicines and breastfeeding
- Any complementary or alternative medications taken by a breastfeeding mother may pass into the milk.
- Complementary and alternative medicines can be purchased without prescription from pharmacies, health food stores and supermarkets.
- For most complementary or alternative medicine products there is not enough documented information to determine their safety in breastfeeding.
- Some complementary and alternative medicines may not be recommended for breastfeeding mothers.
- Encourage breastfeeding mothers taking any complementary or alternative medicines to discuss its safety with their doctor or pharmacist.
Illegal drugs or substance use and breastfeeding
- The priority in recommendations about illegal drug use and breastfeeding is the safety of the baby.
- Illegal drugs or substance use (including alcohol and nicotine) can have harmful effects on the breastfed baby, and may cause sedation in both mother and baby.
- Individual circumstances need to be considered when making recommendations to mothers about using substances and breastfeeding their babies.
- The National Prescribing Service website and Medicines Line 1300 633 424 (local call charge) provide information about medications.
- The Drugs and Lactation Database (LactMed) is a peer-reviewed and fully referenced database of drugs that breastfeeding mothers may be exposed to. Among the data included are maternal and infant levels of drugs, possible effects on breastfed infants and on lactation, and alternate drugs to consider.
- Child and Youth Health Practice Manual, Queensland Government (PDF, 3.6MB)
- Maternity and Neonatal Clinical Guideline: Establishing breastfeeding (PDF 401 kB)
- Maternity and Neonatal Clinical Guideline Supplement: Establishing breastfeeding
(PDF 234 kB)