Breastfeeding and Drugs: Drugs Deemed Safe

Information about what drugs are safe to use during breastfeeding.breastfeeding

A common reason for the cessation of breastfeeding is the use of medication by the nursing mother and advice by her physician to stop nursing.  Of course, if you don’t have to take drugs, whether they are over the counter, or prescription, it is always for the best.

This information is important not only to protect nursing infants from untoward effects of maternal medication but also to allow effective pharmacological treatment of breastfeeding mothers.

Below is a list of drugs deemed safe to take by the American Academy of Pediatrics.

Maternal Medication Usually Compatible With Breastfeeding and any effects on the baby :

Acetaminophen
Acetazolamide
Acitretin
Acyclovir — Drug is concentrated in human milk
Alcohol (ethanol) — With large amounts, drowsiness, diaphoresis, deep sleep, weakness, decrease in linear growth, abnormal weight gain; maternal ingestion of 1 g/kg daily decreases milk ejection reflex
Allopurinol
Amoxicillin
Antimony
Atropine
Azapropazone (apazone)
Aztreonam
B1 (thiamin)
B6  (pyridoxine)
B12
Baclofen
Barbiturate
Bendroflumethiazide  — Suppresses lactation
Bishydroxycoumarin (dicumarol)
Bromide  — Rash, weakness, absence of cry with maternal intake of 5.4 g/d
Butorphanol
Caffeine — Irritability, poor sleeping pattern, excreted slowly; no effect with moderate intake of caffeinated beverages (2–3 cups per day)
Captopril
Carbamazepine
Carbetocin
Carbimazole — Goiter
Cascara
Cefadroxil
Cefazolin
Cefotaxime
Cefoxitin
Cefprozil
Ceftazidime
Ceftriaxone
Chloral hydrate —  Sleepiness
Chloroform
Chloroquine
Chlorothiazide
Chlorthalidone — Excreted slowly
Cimetidine — Drug is concentrated in human milk
Ciprofloxacin
Cisapride
Cisplatin — Not found in milk
Clindamycin
Clogestone
Codeine
Colchicine
Contraceptive pill with estrogen/progesterone — Rare breast enlargement; decrease in milk production  and protein content (not confirmed in several studies)
Cycloserine
D (vitamin) —  follow up infant’s serum calcium level if mother receives pharmacological doses
Danthron — Increased bowel activity
Dapsone —  sulfonamide detected in infant’s urine 191, 219
Dexbrompheniramine maleate with d-isoephedrine — Crying, poor sleeping patterns, irritability
Diatrizoate
Digoxin
Diltiazem
Dipyrone
Disopyramide
Domperidone
Dyphylline — Drug is concentrated in human milk
Enalapril
Erythromycin — Drug is concentrated in human milk
Estradiol — Withdrawal, vaginal bleeding
Ethambutol
Ethanol (cf. alcohol)
Ethosuximide — drug appears in infant serum
Fentanyl
Fexofenadine
Flecainide
Fleroxacin — One 400-mg dose given to nursing mothers; infants not given breast milk for 48 hours
Fluconazole
Flufenamic acid
Fluorescein
Folic acid
Gadopentetic (Gadolinium)
Gentamicin
Gold salts
Halothane
Hydralazine
Hydrochlorothiazide
Hydroxychloroquine — Drug is concentrated in human milk
Ibuprofen
Indomethacin — Seizure (1 case)
Iodides — May affect thyroid activity; see iodine
Iodine — Goiter
Iodine (povidone-iodine, eg, in a vaginal douche) — Elevated iodine levels in breast milk, odor of iodine on infant’s skin
Iohexol
Iopanoic acid
Isoniazid– acetyl (hepatotoxic) metabolite secreted but no hepatotoxicity reported in infants
Interferon-a
Ivermectin
K1 (vitamin)
Kanamycin
Ketoconazole
Ketorolac
Labetalol
Levonorgestrel
Levothyroxine
Lidocaine
Loperamide
Loratadine
Magnesium sulfate
Medroxyprogesterone
Mefenamic acid
Meperidine
Methadone
Methimazole (active metabolite of carbimazole)
Methohexital
Methyldopa
Methyprylon — Drowsiness
Metoprolol — Drug is concentrated in human milk
Metrizamide
Metrizoate
Mexiletine
Minoxidil
Morphine — infant may have measurable blood concentration
Moxalactam
Nadolol — Drug is concentrated in human milk
Nalidixic acid — Hemolysis in infant with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency
Naproxen
Nefopam
Nifedipine
Nitrofurantoin — Hemolysis in infant with G-6-PD deficiency 305
Norethynodrel
Norsteroids
Noscapine
Ofloxacin
Oxprenolol
Phenylbutazone
Phenytoin — Methemoglobinemia (1 case)
Piroxicam
Prednisolone
Prednisone
Procainamide
Progesterone
Propoxyphene
Propranolol
Propylthiouracil
Pseudoephedrine — Drug is concentrated in human milk
Pyridostigmine
Pyrimethamine
Quinidine
Quinine
Riboflavin
Rifampin
Scopolamine
Secobarbital
Senna
Sotalol
Spironolactone
Streptomycin
Sulbactam
Sulfapyridine — Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant’s milk
Sulfisoxazole — Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant’s milk
Sumatriptan
Suprofen
Terbutaline
Terfenadine
Tetracycline — negligible absorption by infant
Theophylline — Irritability
Thiopental
Thiouracil — drug not used in United States
Ticarcillin
Timolol
Tolbutamide — Possible jaundice
Tolmetin
Trimethoprim/sulfamethoxazole
Triprolidine
Valproic acid
Verapamil
Warfarin
Zolpidem

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