Medication Dos and Donts While Breastfeeding

Today I will be discussing something we get a lot of questions about at Sinai and that’s medication safety while breastfeeding! Lots of moms call our unit, our lactation consultants, or their doctors with these questions in their first weeks of postpartum. Most things are perfectly fine to take but to be safe, here are a few lists of things you can take, you should ask your doctor about, you shouldn’t take, and what to do if you do take something you don’t want baby to get.

What You Can Take: 

  • For pain- Tylenol or ibuprofen (motrin)
  • For a viral infection- Acyclovir
  • For another infection- Cephalosporins
  • For heart burn/upset stomach- Maalox, Mylanta
  • For Birth Control- Progestin ONLY
  • Lung Problems- Prednisone
  • Stuffy Nose/Allergies- Afrin nasal spray, antihistamines,
  • Asthma- Albuterol inhalers
  • For Constipation- Colace, Senna (mild laxatives)
  • For heart conditions- most medications are safe, including metoprolol, verapamil, procardia, etc.

What to Ask Your Doctor About Before Taking (Most likely are medications you take regularly or if you cannot find a substitute in the safe list): 

  • ACE inhibitors (heart conditions)
  • Anticholinergics (These are used to treat gallbladder spasm and can dry up milk supply)
  • Seizure medications, including Depakote, Dilantin, Tegretal (DO NOT take ehtosuximide, phenobarbital, and primidone)
  • First generation antihistamines including benadryl
  • INH drugs (used to treat tuberculosis)
  • Barbiturates
  • Wellbutrin (anti depressant)
  • Clindamycin (antibiotics)
  • Decongestants (will often reduce milk supply)
  • Fluconazole (anti-fungals)
  • Histamine H2 Blockers- Cimetidine, Ranitidine (Zantac), famotidine (Pepcid)
  • Labetalol
  • Hydrochlorothiazide
  • Ativan
  • Metoclopramide (Reglan)- will often increase milk supply (limit of a number a week to prevent engorgement
  • Midazolam (versed)
  • Alleve (often fine once baby is 1 month or more)
  • Prilosec
  • Serax
  • Paxil
  • Diprivan
  • Quinidine
  • Cipro, Levaquin
  • Salicylates- Aspirin (often fine for occasional use)
  • Zoloft
  • Spironolactone (aldactone)
  • Imitrex
  • Tetracyclines (doxycycline)- can be taken for less than 14 days
  • Trazadone
  • Tricyclic antidepressants (Elavil, Tofranil, Pamelor)
  • Verapamil

What you SHOULD NOT Take: (Consult your doctor if medication is necessary for your well-being) 

  • Acebutolol (Sectral)
  • Atenolol (Tenormin)
  • Antihistamine/decongestant combinations may reduce milk supply. If you have a cold- take antihistamines only if able to prevent decrease in milk supply
  • Benzodiazepines including Valium
  • Antidepressants/mood stabilizers including Celexa, Sinequan, Lexapro, Prozac, Lithium, Serzone, and Effexor
  • Seizure medications including: Primodine, Lamotrigine (Lamictal), and Ethosuximide (Zarontin)
  • Blood pressure or heart medications including Nadolol (Corgard), Amiodarone, Anti-lipid drugs, large doses of aspirin, and Thiazide diuretics
  • Neoplastic/Cancer Treatment Drugs
  • Clozapine
  • Iodide products
  • Iodine (radioactive, contrast dye)
  • Cocaine
  • Nicotine
  • Large amounts of alcohol


What to do if you take one of the above drugs: 

  • Feed baby formula and pre-pumped breast milk for a few days if able
  • “Pump and Dump”- if you have 1-2 glasses of alcohol or take one of the above pills once, pump for 15-20 minutes 1 hour after taking the pill or alcohol and dump the breastmilk. This will rid your milk of the alcohol
  • Contact your doctor or lactation consultant


You can always ask a professional if you are unsure, better safe than sorry! And please email me if you have any specific or further questions!


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