Medications not to use while breastfeeding

Taking medications while breastfeeding is generally safe. There are issues which warrant attention:

1. Infants of less than 2 months old are most likely to experience adverse effects due to drug exposure from breastmilk

2. Some drugs are contraindicated during breastfeeding because they directly cause harm to the baby

3. Other drugs are contraindicated during breastfeeding because they can inhibit lactation

A simple measure to reduce drug exposure to a breastfed infant is to take the medication immediately after breastfeeding or just before the baby's longest sleeping period.

Here's a list of drugs which are commonly used and whether or not they are safe during pregnancy:

Acetaminophen
ASA - may cause Reye's syndrome and bleeding in the infant
Ibuprofen
Naproxen
Ketoprofen
First Generation Antihistamines - Low dose occasssional use is safe; may reduce milk supply and cause drowsiness, irritability, colickiness in child
Second Generation Antihistamines (Loratidine considered DOC)
DM and Guaifenesin
Pseudoephedrine, Phenylephrine - Reduces milk flow; also may cause irritability in babies
Cromolyn Sodium
Aluminum Hydroxide, Magnesium Hydroxide, Calcium Carbonate
Cimetidine, Ranitidine, Famotidine, Nizatidine - Famotidine and Nitazidine preferred because of lower drug concentration in breastmilk
Omeprazole - safe at 20mg/day
Bismuth Subsalicylate - link between salicylates and Reye's syndrome
Attapulgite
Loperamide
Simethicone
Psyllium
Bisacodyl
Cascara
Docusate
Castor Oil
Mineral Oil
Topical Antibiotics
Topical Antifungals - may be applied to the breast and nipple, wipe off excess
Topical Hydrocortisone - may be applied to the breast and nipple, wipe off excess
Iodine, Povidone Iodine, Iodide - Concentrated in breastmilk and can cause thyroid problems in infant
Large amounts of Alcohol - Can cause drowsiness, decreased linear growth and abnormal weight gain in babies
2 cups of Caffeine per day - May cause irritability in baby if more is ingested
Echinacea - Not enough data
Melatonin - May reduce prolacting and oxytocin to decrease milk production, avoid