But Is It Safe for My Baby? Medications and Breastfeeding

Thomas W. Hale
Mothering Issue 111 March/April 2002

The decision to prescribe medication for a breastfeeding mother is one of the most contentious areas in the clinical practice of medicine. For legal reasons alone, most manufacturers and many physicians advise patients to discontinue breastfeeding while they take various medications. Look at any package insert; invariably, the manufacturer recommends that the physician avoid prescribing the drug for breastfeeding mothers. Often doctors advise nursing mothers to “pump and dump” while taking an antibiotic, not knowing that they may be initiating a dangerous spiral toward a poor milk supply, or endangering the infant by introducing a poorer food source such as formula early on.

The fact is that all medications enter breastmilk, but most are so low in concentration that they have no clinical effect on infants. There are thousands of research papers illustrating this point. With few exceptions, most drugs can be safely used by breastfeeding mothers. So the decision about whether to take the drug and breastfeed, or to risk the hazards of introducing artificial formulas to your infant, is really up to each mother.

Most authoritative sources suggest that if the daily dose to the infant is less than 10 percent of the mother’s dose, it is unlikely to bother the infant. This is generally accurate, and very few drugs exceed this limit. The American Academy of Pediatrics has published an extensive list of drugs acceptable for use by breastfeeding mothers. Most physicians are not aware of this, unfortunately, and it may be a nursing mother’s job to bring this information to them.

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