Most medications are safe to take while breastfeeding, and for many mothers, the benefits of continuing necessary medical treatment often outweigh potential risks. According to the Centers for Disease Control and Prevention (CDC), while some medications can pass into human milk, most have little or no adverse effects on the infant or milk production.

However, some medications should be avoided or used with caution—especially when considering the duration of use and your baby's age. This guide will help you understand which medications are generally safe, highlight possible adverse effects, and provide resources to support informed decision-making for both you and your baby.

Where Can You Look for Reliable Information?

When navigating medication use while breastfeeding, reliable information is essential. Several trusted resources provide evidence-based guidance to help mothers and healthcare providers make safe, informed decisions. These tools offer details on possible adverse effects, drug levels in breast milk, and recommendations for the safest alternatives to protect both mom and baby.

  • LactMed Database (NIH): A comprehensive lactation database maintained by the National Institutes of Health (NIH), offering up-to-date information about medications, their levels in mother's milk, and any potential impact on newborns.

  • InfantRisk Center: Provides evidence-based guidance on medication use during breastfeeding, helping mothers and clinicians make informed choices.

  • American Academy of Pediatrics (AAP): Recommends assessing the necessity of a medication, potential effects on milk production, and the baby’s developmental stage when prescribing drugs for a breastfeeding mother.

  • Academy of Breastfeeding Medicine (ABM): Offers detailed protocols and clinical guidance to help healthcare providers safely support mothers who are managing medication use during lactation.

Pain Medications During Labor, Delivery, and Early Postpartum

Pain relief is an essential part of labor and postpartum care. Most medications used for pain management are compatible with breastfeeding when used appropriately and monitored carefully. With the right support, most babies tolerate these medications well.

Common options include:

  • Acetaminophen: Often used for mild to moderate pain after delivery. Considered safe for breastfeeding mothers, with minimal risk of adverse effects in newborns.

  • Ibuprofen: Frequently used postpartum for pain or after cesarean delivery. Safe for short-term use, as only small amounts pass into your milk.

  • Opioid/Narcotic pain relievers: May be used for severe pain during or after delivery, including cesarean birth. When opioids are needed, providers generally recommend the shortest possible time at the lowest effective dose. With careful monitoring, most babies tolerate short-term opioid use well.

  • Epidural or spinal analgesia: These methods are generally considered safe while breastfeeding. Some studies note that newborns may be a little sleepy in the first hours after birth, which can make early feedings more challenging. These effects are usually short-term, and long-term breastfeeding outcomes are typically unaffected.

Key Considerations:

  • Timing: When taking oral or IV narcotic pain medications, try to do so immediately after feeding your baby or before their longest sleep stretch. This can help minimize the amount of medication passed onto your baby.

  • Monitoring: Keep an eye on your baby for sedation, feeding difficulties, or any other possible adverse effects. Most babies tolerate pain medications well, but it’s helpful to be attentive in the early days.

  • Consultation: Always discuss postpartum pain management with your healthcare provider, lactation consultant, or pharmacist, especially if you are taking multiple medications or have any concerns about their effect on your breastfeeding infant.

Cold and Cough Medications

  • Cough suppressants and antihistamines: Most are safe for breastfeeding mothers, though some may cause mild sedation in babies. When possible, choose non-drowsy options.

  • Decongestants: Many common OTC cold remedies are generally safe for short-term use. Pseudoephedrine, however, is regulated and must be obtained directly from a pharmacist, so mothers are unlikely to take it unknowingly.

    • While pseudoephedrine is usually considered safe during breastfeeding, some reports suggest it can cause a significant reduction in milk supply, particularly in mothers who are 6 or more months postpartum. Mothers should use caution or avoid pseudoephedrine while breastfeeding.

  • Guidance: Always review the package insert and check with your healthcare provider before using any over-the-counter or prescription medications to ensure safety for both you and your baby.

Antibiotics

Most antibiotics are considered compatible with breastfeeding and are unlikely to cause harm to your little one. Occasionally, some babies may experience mild diarrhea or temporary changes in gut flora, but these effects are usually short-lived. Some mothers find that taking a probiotic during or after a course of antibiotics can help support both their own and their baby’s gut health—ask your healthcare provider if this might be right for you.

Mental Health Medications

Taking antidepressants or other mental health medications is sometimes necessary to support your own well-being, which is also important for caring for your baby. Many antidepressants are considered compatible with breastfeeding, though some may be better options than others depending on your individual needs. Your healthcare provider can help you select the safest and most effective medication for your needs.

Asthma and Allergy Medications

Most asthma medications, including inhaled steroids, are considered safe for breastfeeding mothers and are unlikely to affect the infant. Maintaining good asthma control is important for your health and your ability to care for your baby.

Oral antihistamines should be used with caution, as some may cause mild sedation or drowsiness in your baby. When possible, choose non-drowsy formulations and discuss options with your healthcare provider to ensure safety for both you and your infant.

Supplements and Herbal Medicine

Herbal products and dietary supplements can vary in strength, may contain contaminants, and are poorly regulated. It’s important to discuss any supplements or herbal remedies with your healthcare provider before using them while breastfeeding.

 

B.R.A.I.N. Questions to Ask Before Taking a Medication

When you need to take a medication, use the B.R.A.I.N. approach to guide your discussion with your healthcare provider. This helps you weigh benefits, risks, and alternatives thoughtfully.

  • B – Benefits: What are the benefits of taking this medication for me? How will it help my health or recovery?

  • R – Risks: What are the potential risks to me or my breastfeeding infant? What should I watch for?

  • A – Alternatives: Are there safer or non-medication alternatives that could help? Could changing the timing or dose make a difference?

  • I – Instincts: How do I feel about taking this medication? Does it feel safe for me and my baby?

  • N – Nothing / No action: What might happen if I choose not to take this medication? Are there consequences to waiting or using a different approach?

With the right information and support, most mothers can safely continue both breastfeeding and necessary medical treatment. When in doubt, reach out to your care team to protect your baby’s health while taking care of your own.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.