Selecting Over-the-Counter Drugs as a Breastfeeding Mother:5 Tips from a Pharmacist
By Dr. Frank J. Nice
If you are a breastfeeding mother, any medication you take could potentially be passed to your infant through breast milk. Even if the medication is entirely safe for you, there may be harmful consequences for your baby. In fact, there are some very well-known, trusted brands and ingredients that are not safe for this very reason.
While avoiding certain medications is a familiar concept for someone who has recently gone through a pregnancy, the rules concerning breastfeeding are not so well defined. This isn’t an issue when taking prescription drugs, which must be approved by a professional, but you may find yourself lacking guidance when it comes to over-the-counter (OTC) health products.
The OTC products you use can still harm your baby or affect your breast milk production. So what’s a breastfeeding mom to do? These are basic strategies to follow:
Avoid products that do not have enough information. Even herbal remedies or products like caffeinated drinks and acne medication should not be trusted until you know whether they are compatible with breastfeeding. If the information you’re able to find about an OTC product is inconclusive, lacks scientific research, or comes from a dubious source (i.e., is not endorsed by a licensed health professional), it’s best to stay away from it unless your doctor or pharmacist tells you otherwise. See the list of resources in the sidebar that can help you find trustworthy information.
Use regular-strength products whenever possible, and do not take more than the recommended dose. If the ingredients in the product are safe for breastfeeding, an extra-strength version is not likely to cause severe harm. However, there is no need for your infant (or you) to be exposed to extra amounts of a drug. Terms like “extra strength” or “maximum strength” can cause confusion, and they are sometimes only listed on packaging to make a product sound more effective. So, before using a medication, check if there is a regular-strength or original-strength version. If not, look at similar products or alternative brands, and compare the labels. Choose the product with the lowest amount of the active ingredient, or, depending on the severity of your health needs, choose the lowest amount you think will treat your symptoms.
Avoid long-acting products. This protects your infant from being exposed to a drug for a longer period of time than necessary, especially if side effects or an allergic reaction are possible. Look for products you can take every 4–6 hours, and avoid ones that say they will last 12 hours or more. Again, you can use your discretion depending on your health needs. For example, if you have severe allergies, it might be worth it to take an allergy product that lasts all day. However, it is best to discuss decisions like this with your doctor and/or pharmacist, and it may be best to test your baby’s reaction by using a short-acting product first.
Take products with single active ingredients. It is best to take a medication that has one or two specific ingredients that will treat a particular condition rather than exposing your breastfeeding infant and yourself to ingredients that you don’t need. Taking medications with only one or two ingredients will also help you avoid accidentally double dosing (for example, you should not take Tylenol along with DayQuil, since DayQuil already contains acetaminophen).
Always choose the safest product. This may seem obvious, but it’s worth saying. Read the labels. Do your homework. Research the possible side effects that you or your infant might experience when taking an OTCdrug, and make comparisons. A doctor, lactation consultant, or pharmacist can help you if you are unsure. If you talk to health professionals, make sure they know all of your circumstances so they can give you an accurate recommendation.
This may feel overwhelming, but giving up on breastfeeding for the purpose of taking a certain medication is not necessary in most instances. There are very few dangerous medications that do not have a suitable alternative.
With this in mind, I created a simple, thorough reference guide to OTC products that can help you reach your breastfeeding goals. If you are looking for clear answers to help you choose a safe and effective product for your health needs, I recommend my new book, The Breastfeeding Family’s Guide to Nonprescription Drugs and Everyday Products.
This book will help you safely maintain your personal health and minimize any stress, fear, or pain you may be experiencing. That way, you can focus on what’s most important: building a beautiful, lasting bond with your children.
Where to find information about whether a product is safe to use while breastfeeding:
The Breastfeeding Family’s Guide to Nonprescription Drugs and Everyday Products - Provides safety information for over 1700 specific over-the-counter products, plus active ingredients. Includes social drugs, personal hygiene products, herbal remedies, sunscreens, dietary products, and more.
Breastfeeding Online - Offers all kinds of information to support breastfeeding, including breastfeeding-safe therapies for mastitis, thrush, engorgement, insufficient milk supply, and nipple vasospasm, among others.
Lactmed Search - A peer-reviewed and fully referenced National Library of Medicine database of drugs showing possible effects on breastfed infants and on lactation.
Infant Risk Center - A worldwide call center that helps parents, lactation consultants, and doctors evaluate infant risk from exposure to multiple drugs, with the goal of continuing breastfeeding.
ABOUT THE AUTHOR
Dr. Frank J. Nice has practiced as a consultant, lecturer, and author on medications and breastfeeding for over 45 years. He holds advanced degrees in pharmacy administration and public administration and certification in public health pharmacy. He has worked for the U.S. Public Health Service, practiced at the National Institutes of Health, and served as a pharmacist and project manager at the Food and Drug Administration. Dr. Nice has multiple published books and has authored over 50 peer-reviewed articles on the use of prescription medications, over-the-counter products, and herbals during breastfeeding.