When a Nursing Mother is Ill and Needs to Take Medications

When a mother becomes ill, she should not interrupt breastfeeding for fear that she may make her baby sick. Breast milk passes immunity to the baby in many circumstances. Frequent hand washing will also decrease the risk of contagiousness.

If you are nursing while ill, it is generally best to avoid most medications. If you wish to take medicine, the following medicines may be taken safely (at the recommended dose) without risk to your baby:

For fever: Acetaminophen, Ibuprofen

For colds: Agents such as promethazine, dexchlorpheniramine and diphenhydramine are considered to be safe through extensive usage, although it would be prudent to monitor for evidence of sedation or irritability in the infant. There is less data on the non-sedating antihistamines, although loratadine and fexofenadine are likely to be safe due to low transfer into milk.

For pain: Acetaminophen, Ibuprofen, codeine, Demerol, Naprosyn

For infection: Antibiotics do not usually produce adverse effects in breast-fed infants. Antibiotics such as penicillins, cephalosporins and macrolides are considered to be compatible with breastfeeding 

Decongestants:

A short course of pseudoephedrine (weight-adjusted dose < 4%) is unlikely to be problematical. However, topical decongestant nasal sprays or drops are usually preferred due to lower infant exposure.

Drugs affecting milk:

Drugs can affect milk secretion or composition by affecting factors such as mammary gland development, milk secretion and hormonal regulation of lactation. Prolactin is necessary for human milk secretion and may be affected by drug use. Dopamine agonists such as cabergoline reduce prolactin and are sometimes used therapeutically to stop lactation. Dopamine antagonists such as metoclopramide and most antipsychotics may increase prolactin and milk production. Other drugs that have been associated with causing hyperprolactinaemia include SSRIs and opioids