Breastfeeding and Medications: How Do I Know what is Safe to Take?
As you focus on the health of your new baby, it’s important to stay healthy yourself. Sometimes ensuring your own health – from managing minor aches and pains to maintaining emotional balance – requires medication. Breastfeeding adds a layer of scrutiny to the pills you pop because a small dose of your medications will transfer into your breast milk. It is essential to know where to find information about medication safety while breastfeeding.
The first source you should consult regarding medications that may affect your baby is your pediatrician. She will be most knowledgeable about what is acceptable for your baby to consume based on the age and health condition of your child. Premature babies, newborns or any infant with an existing condition may be at greater risk of adverse 
reactions to adult medication. Also, if your baby is older and breastfeeding less because you have introduced solids, your pediatrician may be less concerned about potential issues.
Once you select a pediatrician during pregnancy, make her aware of any medications you are taking. Consult her again before introducing new medications as well, and remind her of all drugs you are taking. Sometimes a drug interaction that does not affect adults can cause problems for babies. Additionally, some medications may be given to infants and therefore the small dose a baby receives through breast milk is acceptable. If you want to do some research on your own, there are reference books about breastfeeding and medications as well as dedicated hotlines for this topic.
When you are prescribed a new drug, you may want to let your physician know that you are breastfeeding. Your doctor might know off-hand if the medication could be dangerous to your baby and may be able to suggest an alternative. However, many doctors use the Physicians Desk Reference to look up potential risks and almost every drug shows a warning for pregnant and breastfeeding mothers. This does not necessarily mean it is unsafe so still consult your pediatrician. Also note that the same rules for medication safety do not apply during pregnancy as with breastfeeding so do not use pregnancy warnings as a guide.
If you cannot find a safe alternative to a drug you are prescribed, ask yourself if it is absolutely necessary to treat your condition immediately. You may be able to postpone the medication until you wean your baby. However that is not always possible. You may need to temporarily discontinue breastfeeding while you undergo your course of medicine. During this time, pump as much as possible to keep your milk supply available and set a goal to return to breastfeeding as soon as the medication is out of your body.
Be sure to consider how a medication will affect your milk supply and nursing schedule too. Drugs that are dehydrating or cause drowsiness can be particularly disruptive to breastfeeding. If you know these side effects in advance, you can work to counteract them by drinking more throughout the day or planning for your partner to give a bottle of breast milk while you catch a nap.
If you do proceed with a course of medicine, be sure to watch your baby closely for any signs of reactions. The most common negative responses to adult medications in babies are fussiness, gassiness, refusal to eat, lethargy and rashes. Keep a watchful eye for these symptoms and contact your pediatrician immediately if any emerge.
Most over-the-counter medications are generally safe while breastfeeding. But don’t take any chances with your baby’s health. Pediatricians and help lines are happy to answer your questions and address concerns so don’t be afraid to use them as a resource.
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