Medications and Breastfeeding

Philippa
Author
By Philippa Pearson-Glaze IBCLC
Last Revised
Share184
Tweet
Pin
184 Shares

Most medications are compatible with breastfeeding because usually only a very small proportion actually reaches the breast milk. The amount of medication that reaches a baby through breast milk will depend on a number of the drugs’ properties such as half life (the time it takes for half the drug to be eliminated from the body), molecular size, fat solubility, protein binding and what happens to it in the baby’s gut.1. If one drug isn’t recommended there is often an alternative that is safer or more compatible. Many diagnostic tests are compatible with breastfeeding as well.

This article

This article looks at a mother’s options if her doctor asks her to stop breastfeeding in order to take a medication and provides resources to check drug compatibility with breastfeeding.

My doctor told me to stop breastfeeding

Sometimes a breastfeeding mother may need to take a medicine that her health professional says isn’t compatible with breastfeeding. If your doctor tells you to stop breastfeeding in order to take a specific medication, check whether they have consulted one of the resources specific to breastfeeding and medications below, or whether a more compatible drug could be prescribed. The drug companies package insert may not be a reliable source of information on drug safety when breastfeeding. Dr Thomas Hale explains:

Unfortunately, most healthcare professionals simply review the package insert or advise the mother not to breastfeed without having done a thorough study of the literature to find the true answer. Discontinuing breastfeeding is often the wrong decision, and most mothers could easily continue to breastfeed and take the medication without risk to the infant. Even the FDA [US Food and Drug Administration] has recognized this and now recommends that drug manufacturers carry out studies to determine milk levels of their drug.

Explain that breastfeeding is important

Explain to your doctor how important breastfeeding is to you and your baby. As Jack Newman, a Canadian paediatrician and breastfeeding expert, says below, breastfeeding is too important to mother and baby to be stopped unnecessarily:

There are some rare situations in which a mother’s or baby’s illness means that breastfeeding cannot continue. Too often, though, health professionals recommend weaning the baby without thinking. In the vast majority of cases, stopping breastfeeding is detrimental to the baby and the mother and completely unnecessary. A health professional who is truly supportive of breastfeeding will make every effort to find ways for the mother to continue at the same time as helping her to cope with medical conditions.

Checking medications and breastfeeding

Although most medications are compatible with breastfeeding, a health professional will need to review the safety of each medication because there are a few drugs that are not compatible. Reputable resources for checking medications and breastfeeding include:

#1 UK Breastfeeding Medicines Advice Service (UKDILAS)

The specialist UKDILAS service (previously the UK Drugs in Lactation Advisory Service) from the Specialist Pharmacy Service (SPS) provides evidence-based information and advice to healthcare-professionals on the use of medicines during breastfeeding. The National Institute for Health and Care Excellence (NICE) recommend health professionals and pharmacists consult UKDILAS when prescribing to breastfeeding mothers.2

#2 Hale’s Medications and Mothers’ Milk

  • Book. Clinical pharmacologist, Dr. Thomas Hale is the author of a comprehensive and regularly updated book evaluating the compatibility of medications with breastfeeding: Hale’s Medications & Mothers’ Milk: A Manual of Lactational Pharmacology, 2025-2026.
  • Website. There is also an online version of the book at Hale’s Medications and Mothers’ Milk for health professionals (requires a subscription).
  • Apps. Available as mobile apps for android or apple devices from Infant Risk Center: MommyMeds for mothers and InfantRisk aimed at health professionals.

#3 LactMed (website)

A free Drugs and Lactation Database from the US National Library of Medicine—LactMed online.

#4 E-lactancia (website)

E-lactancia is a free online resource from APILAM (Association for Promotion and Cultural and Scientific Research of Breastfeeding) in Spain. It includes information on breastfeeding and phytotherapy (plants), homeopathy, cosmetic and medical procedures, contaminants, maternal and infant diseases and more. Information is available in Spanish or English.

#5 Drugs and breastfeeding (Swedish)

Läkemedel och amning; a free online drugs and breastfeeding database for health professionals in Swedish by Stockholm County Council.

#6 The Breastfeeding Network

#7 Telephone helplines

#8 Books

In addition to Hale’s Medications & Mothers’ Milk: A Manual of Lactational Pharmacology 2025-2026: other helpful books that discuss the safety of individual drugs when breastfeeding include:

medications and breastfeeding

If you do need to stop breastfeeding

If you do need to wean due to medical reasons How to Stop Breastfeeding discusses how to stop breastfeeding without getting engorgement or mastitis.

Summary

If your doctor is not supportive of breastfeeding and asks you to stop breastfeeding to take a medication, explain how important breastfeeding is to you and your baby. Most medications are compatible with breastfeeding. If a particular drug is not compatible, alternatives with a better safety record are often available. Share the resources listed above and discuss with your physician whether an alternative treatment is possible.

*Extract reproduced by permission from Pinter & Martin

Share184
Tweet
Pin
184 Shares