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Although many medications are safe to take when you're breastfeeding, most drugs pass into your milk in some amount, and some may even affect your milk supply. To be safe, always check with your healthcare provider or a pharmacist before taking any over-the-counter medication or prescription drug.
Our information was compiled and reviewed by Philip Anderson, pharmacist and editor of LactMed, the U.S. National Library of Medicine's database on drugs and lactation. If you have questions about how a specific drug might affect your breast milk or your baby, check the LactMed online database and talk with your provider or a pharmacist.
MotherToBaby is another good source of information on medication safety during pregnancy and while breastfeeding. You can also visit the organization's website to learn about free and confidential consultations with their experts, available by phone, text, online chat, or email.
How does the medicine I take affect my breastfeeding baby?
The amount of medication that gets into breast milk and how it affects a baby depends on such factors as your baby's age, the type of medicine, the dose, and the way it's taken.
Possible side effects a baby may have after exposure to medication include diarrhea, vomiting, and unusual sleepiness or irritability. And some medications can lower your milk production, possibly leading to poor weight gain.
Do I need to pump and dump while I'm taking medicine?
It depends on the type of medicine you're taking. Your provider may advise you to pump and dump while you're on certain medications because some harmful drugs can be passed to your baby through your milk.
"Pump and dump" means using a breast pump to empty your breasts and then dumping out the milk you collect. Doing this when you can't or shouldn't give your milk to your baby enables you to keep up your milk supply and eventually start nursing again.
In some cases, it might be possible to take your medication immediately after nursing, wait a while, then nurse your baby again just before it's time to take your next dose. Ask your provider if this approach is safe for your baby.
If your provider advises you to stop breastfeeding while taking medicine, ask if there is an alternative medicine that's safe for your baby. LactMed lists possible alternatives for many medicines.
If you know in advance that you'll have to pump and dump, consider pumping and freezing your milk ahead of time, so you'll have enough stockpiled before you start taking your medication.
Have you ever needed to "pump and dump" your breast milk? Take our poll.
Which medicines are safe to take when breastfeeding?
These medications are considered safe to take in standard doses when you're nursing.
| Name of Drug (Brand Name) | Use |
|---|---|
| Acetaminophen (Tylenol) | Pain reliever |
| Acyclovir and valacyclovir (Zovirax, Valtrex) | Antiviral for herpes infections |
| Antacids (Maalox, Mylanta) | Used to treat upset stomachs |
| Bupivacaine (Marcaine) | Local anesthetic |
| Caffeine (up to 300 mg, or 2-3 drinks a day, such as coffee and soft drinks) | A stimulant |
| Cephalosporins (Keflex, Ceclor, Ceftin, Omnicef, Suprax) | Antibiotics for lung, ear, skin, urinary tract, throat, and bone infections |
| Clotrimazole (Lotrimin, Mycelex) | Antifungal used to treat yeast and other fungal infections |
| Contraceptives (progestin-only) (Micronor, Norplant, Depo-Provera) | Used for birth control |
| Corticosteroids (Prednisone) | Used to treat inflammation of joints and other conditions |
| Decongestant nasal sprays (Afrin) | Used to treat stuffy noses |
| Digoxin (Lanoxin) | Used to treat heart problems |
| Erythromycin (E-Mycin, Erythrocin) | Used for skin and respiratory infections |
| Fexofenadine (Allegra) | Antihistamine for allergies and hay fever |
| Fluconazole (Diflucan) | Antifungal used to treat yeast infections |
| Heparin | Anticoagulant used to keep blood from clotting |
| Ibuprofen (Motrin, Advil) | Pain reliever |
| Inhalers, bronchodilators, and corticosteroids (Albuterol, Vanceril) | Used for asthma |
| Insulin | For diabetes (required dosage may drop up to 25 percent during lactation) |
| Iodinated contrast media | Used in imaging procedures (such as an X-ray or MRI) |
| Labetalol | A beta-blocker used to treat high blood pressure (Check with your provider if you're nursing a preterm baby.) |
| Laxatives, bulk-forming and stool-softening (Metamucil, Colace) | Used to treat constipation |
| Lidocaine (Xylocaine) | A local anesthetic |
| Loratadine (Claritin) | Antihistamine for allergies and hay fever |
| Low molecular weight heparins, enoxaparin and dalteparin (Lovenox and Fragmin) | Anticoagulants |
| Magnesium sulfate | Used to treat preeclampsia and eclampsia; may reduce milk supply |
| Methylergonovine (short courses) (Methergine) | Used to prevent or control bleeding after childbirth |
| Metoprolol (Lopressor) | A beta-blocker used to treat high blood pressure |
| Miconazole (Monistat 3) | Antifungal used to treat yeast infections |
| Nifedipine (Adalat, Procardia) | Used to treat high blood pressure and Raynaud's syndrome of the nipple |
| Penicillin, amoxicillin (Dynapen) | Antibiotics used to treat bacterial infections |
| Propranolol (Inderal) | A beta-blocker used to treat heart problems and high blood pressure |
| Theophylline (Theo-Dur) | Used to treat asthma and bronchitis |
| Tretinoin (Retin-A) | Topical acne cream. Avoid infant contact with cream. |
| Thyroid replacement (Synthroid) | Used to treat thyroid problems |
| Vaccines (except smallpox and yellow fever) | |
| Vancomycin (Vancocin) | An antibiotic |
| Verapamil (Calan, Isoptin, Verelan) | Used for high blood pressure |
| Warfarin (Coumadin, Jantoven) | Anticoagulant used to treat or prevent blood clots |
Which medicines are most likely safe to take when breastfeeding?
Little is known about how these medications affect a breastfeeding infant, but these drugs are most likely safe in typical doses. Any side effects will probably be mild. In rare cases, a baby might have an allergic reaction.
| Name of Drug (Brand Name) | Use |
|---|---|
| ACE inhibitors, Enalapril (Vasotec), Benazepril (Lotensin) | Used to treat high blood pressure |
| Anticholinergic agents (Pro-Banthine) | Used to treat intestinal and gall bladder spasms; may reduce milk supply |
| Anticonvulsants (Depakote, Dilantin, Tegretol) | Used for seizures and mood disorders (Avoid ethosuximide, phenobarbital, and primidone.) |
| Antihistamines, first generation (Benadryl, Chlor-Trimeton) | Used to reduce or prevent allergy symptoms |
| Antituberculars (INH) | Used to treat tuberculosis |
| Azathioprine, low dose (Imuran) | Used to suppress the immune system following organ transplants |
| Barbiturates, except phenobarbital (Fiorinal, Fioricet) | For sedation and tension headaches |
| Bupropion (Wellbutrin) | For depression |
| Citalopram (Celexa) | Antidepressant; can cause infant drowsiness |
| Clindamycin (Cleocin) | Antibiotic used to treat abdominal and vaginal infections |
| Oral decongestants (Sudafed, Entex PSE) | Used to treat congestion associated with colds or allergies; often reduces milk supply |
| Ergonovine, short course | Used to treat uterine bleeding; may reduce milk supply |
| Fluoxetine (Prozac, Serafem) | Used to treat depression |
| Gadolinium (Magnevist, Omniscan) | Contrast agent for MRI studies |
| Histamine H2 blockers cimetidine (Tagamet), ranitidine (Zantac), nizatadine (Axid), and famotidine (Pepcid) | Used to treat stomach problems |
| Hydrochlorothiazide, low dose (HydroDiuril) | Diuretic for high blood pressure |
| Lorazepam (Ativan) | Used to treat anxiety |
| Methimazole (Tapazole) | Used for hyperthyroidism; less than 20 mg/day is probably safe |
| Metoclopramide (Reglan) | Used for gastrointestinal problems and to increase milk supply. Limit to 10 mg 3 times a day for 2 weeks. |
| Midazolam | Sedative used in anesthesia |
| Monoclonal antibodies | Used to treat many conditions, such as rheumatoid arthritis, inflammatory bowel disease, and cancer |
| Naproxen (Naprosyn, Anaprox, Aleve) | Used for pain relief; okay if baby is at least 1 month old |
| Omeprazole (Prilosec) | Used to treat stomach problems |
| Oxazepam (Serax) | Used to treat anxiety |
| Paroxetine (Paxil) | Used to treat depression |
| Propofol (Diprivan) | Sedative used in anesthesia |
| Quinidine | Used to treat heartbeat irregularities |
| Quinolone antibacterials (Cipro, Levaquin, Noroxin) | Used to treat urinary tract infections |
| Salicylates (aspirin) | Used for pain relief |
| Sertraline (Zoloft) | Used to treat depression |
| Spironolactone (Aldactone, Aldactazide) | Used for pain relief |
| Sumatriptan (Imitrex) | Used to treat migraines |
| Tetracyclines | Antibiotic used to treat acne and urinary tract infections |
| Trazodone (Oleptro) | Used for depression and sleep |
| Tricyclic antidepressants (Elavil, Tofranil, Pamelor) | Used to treat depression; nortriptyline preferred, avoid doxepin |
| Verapamil (Calan, Isoptin, Verelan) | Used for high blood pressure |
Which medicines may cause problems when breastfeeding?
The drugs in the following chart should be used with caution. Before taking these drugs, be sure to tell your healthcare provider or a pharmacist that you're breastfeeding, and watch your baby for side effects. If you're nursing a newborn or premature infant, ask your provider if there are alternatives.
| Name of Drug (Brand Name) | Use |
|---|---|
| Acebutolol (Sectral) | A beta-blocker used to treat high blood pressure and abnormal heart rhythms |
| Atenolol (Tenormin) | A beta-blocker used to treat high blood pressure and abnormal heart rhythms |
| Antihistamine/decongestant combinations (Contac, Dimetapp) | Used to treat colds and allergies; may reduce your milk supply |
| Benzodiazepines, long-acting (Librium, Valium, Dalmane) | Used to treat anxiety and for sleep (lorazepam, oxazepam preferred) |
| Chlorthalidone | Diuretic used to treat high blood pressure; may reduce milk supply |
| Clonidine (Catapres) | Used to treat high blood pressure; may reduce milk supply |
| Contraceptives (estrogen-containing) (Ortho-Novum, Lo-Ovral, Loestrin) | Used for birth control; may reduce milk supply. (Use progestin-only products.) |
| Doxepin (Sinequan) | Antidepressant |
| Ergotamine (Cafergot) | Used to treat migraines |
| Escitalopram (Lexapro) | Antidepressant |
| Ethosuximide (Zarontin) | Anticonvulsant used to treat epilepsy |
| Fluorescein IV | Used to diagnose retinal problems |
| Lamotrigine (Lamictal) | Anticonvulsant used for seizures and mood disorders |
| Lithium (Lithobid) | Used to treat bipolar disorder (monitor infant serum levels) |
| Metronidazole (Flagyl) | Antibiotic used to treat some intestinal and genital infections |
| Nadolol (Corgard) | A beta-blocker used to treat high blood pressure and heart problems |
| Narcotics (Tylenol #3, Vicodin, Demerol) | Prescription pain relievers; high risk for dependence and addiction |
| Nefazodone (Serzone) | Antidepressant |
| Nicotine | Smoking can reduce milk supply |
| Nitrofurantoin (Macrobid, Macrodantin) | Antibiotic used to treat urinary tract infections; safe to take if the baby is at least 1 month old |
| Phenobarbital | Sedative and anticonvulsant |
| Piroxicam (Feldene) | Used to treat arthritis and pain |
| Primidone (Mysoline) | Used to treat seizures |
| Reserpine | Used to treat hypertension |
| Sotalol (Betapace) | Used to treat heart problems |
| Thiazide diuretics, long-acting or high doses (Aquatensin, Enduron, Lozol, Renese) | For high blood pressure or edema; high dose may reduce milk supply |
| Venlafaxine (Effexor) | Used to treat depression |
Which medicines are unsafe to take when breastfeeding?
These drugs are not safe for breastfeeding moms to take. Ask your healthcare provider if there is a safer alternative you can take.
If you must take a certain medication, you may not be able to breastfeed, or you may have to stop temporarily. (Ask your provider or a lactation consultant how you can keep up your milk supply until you're ready to breastfeed again.)
| Name of Drug (Brand Name) | Use |
|---|---|
| Amantadine (Symmetrel) | Used to treat the flu or Parkinson's disease; may reduce milk supply |
| Amiodarone (Cordarone) | Used to treat heart problems |
| Antilipemics, excluding resins (Lescol, Lipitor, Lopid, Mevacor, Pravacor, Zocor) | Used to lower the level of cholesterol in the blood |
| Antineoplastic agents, except for monoclonal antibodies | Used to treat cancer |
| Aspirin (large doses) | Used to treat arthritis |
| Chloramphenicol | Antibiotic used to treat serious bacterial infections |
| Clozapine (Clozaril) | Used to treat schizophrenia |
| Gold salts (Myochrysine) | Used to treat arthritis |
| Iodide products (Betadine, potassium iodide) | Used for douching or as an expectorant |
| Iodine, radioactive | Used to diagnose and treat hyperthyroidism |
| Metamizole (Dipyrone) | Pain reliever and anti-inflammatory. Banned in the US but available in Mexico (dipirona in Spanish) |
| Salicyclates, large doses (Aspirin) | Used to treat arthritis |
Learn more:
This article was reviewed by:
Philip Anderson, Pharm.D., health sciences clinical professor of pharmacy at the University of California, San Diego
