If you are breastfeeding and plan to take any kind of drug—whether prescription or over-the-counter—be sure to discuss with your doctor or your child's pediatrician. While many medications are safe during breastfeeding, a few can have serious side effects for you and/or your baby—and they are not necessarily the same ones that were most concerning during pregnancy.
What the AAP Recommends
Much is still unknown regarding long-term effects of various kinds of medications on your baby. For this reason, while you are breastfeeding, the American Academy of Pediatrics (AAP) recommends to take medication only when absolutely necessary, and to take the lowest dose for the shortest time possible.
Is your medication short-acting or long-acting?
When possible, use short-acting medications (those eliminated by your body quickly) rather than longer-acting medication. Short-acting medicines are best taken immediately after a nursing session, while longer-acting medicines should be taken just before your baby's longest sleep period. When a short-acting medication is taken immediately after a nursing session, there is a good chance that much of it will already be out of your body's system by the time your baby is ready to nurse again.
Watch for reactions in your baby:
When taking any medication, watch closely for reactions in your baby, including loss of appetite, diarrhea, sleepiness, excessive crying, vomiting, or skin rashes. Call your baby's pediatrician immediately if any of these symptoms appear.
When to express and store your milk:
If your doctor needs to prescribe a potentially harmful drug for a short time, you may express and store your milk until the medication is cleared from your body. The length of time required to clear the drug from your system varies based on the particular medication, but your doctor can advise you about this. Pumping and discarding breast milk exposed to medication is rarely indicated. It is recommended that you have a discussion with both your doctor and a lactation consultant prior to discarding any milk.
Frequent, exclusive breastfeeding (no water, juice, formula, solid foods, or other supplements for the baby), including at least one night feeding, may delay your chances of becoming pregnant during the first six months after birth. However, after about six weeks, especially if you are only partially breastfeeding, you can begin using contraceptives if your milk supply is firmly established. You should discuss the issue with your doctor.
While there are no harmful effects on infants when mothers use birth control, research has shown that birth control pills with high doses of estrogen may decrease milk supply.
Progestin-only pills (sometimes referred to as mini-pills) are least likely to interfere with breastfeeding, although they have increased side effects for the mother.
Consider using condoms, a diaphragm, or a cervical cap and spermicide instead, since these forms of birth control are least likely to interfere with your milk supply.
Homeopathic & Herbal Medicines
While many homeopathic and herbal remedies are generally safe, some remedies may be harmful for breastfeeding women and infants. In many cases, very little scientific research has been done regarding the implications of using such treatments while nursing.
The United States Food and Drug Administration (FDA) does not regulate homeopathic, herbal, or natural remedies. Therefore, there is no nationally approved oversight safety. When taken in large quantities, certain substances create negative effects such as increased blood pressure and reduced milk supply. It's safest to refrain from taking herbs or other homeopathic medications before discussing with your doctor first.
If a homeopathic or herbal remedy must be taken, the same recommendations apply as with any other medication: take the smallest dose possible, and always take right after a nursing to minimize medication amounts in your breast milk.
Always make sure that your doctor is aware of any medications you are taking while you are breastfeeding. Communication is important for optimizing the safety of both you and your baby.