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Breastfeeding and Medications

Too Much Caution?

Some women may get the idea they need to avoid all medications while breastfeeding. This simply isn't the case -- many drugs are perfectly safe to use while breastfeeding! And don't assume that medications unsafe for use during pregnancy are automatically unsafe during breastfeeding. Some drugs that should be avoided in pregnancy pose no risk during breastfeeding. 
Be aware that many Web sites and drug manufacturers recommend that breastfeeding women avoid most medications, without any real science to back up this advice and mainly to avoid legal liability. Unless you find mention of specific risks or specific information, like how much of the drug passes through breast milk, you can assume that most warnings against breastfeeding while taking certain medications are just general legal disclaimers, not actual advice based on real scientific evidence.
These general warnings, often included for every medication, while serving to limit legal liability, do women a great disservice by suggesting that all medications are unsafe to use while breastfeeding.

Where to Find Good Information

Surprisingly, the official prescribing information (the "package inserts") that is approved by the U.S. Food and Drug Administration (FDA) for drugs is often quite out-of-date in terms of breastfeeding data. This is surprising because the package inserts typically contain very up-to-date information about other aspects of medications.
As a result, the package insert is typically not a good source of information about medications and breastfeeding. There are a few excellent references that healthcare providers use, but most women do not have access to these expensive references. You can call your obstetrician, your child's pediatrician, or your pharmacist, but expect to wait for an answer. Your healthcare provider will have to take the time to look up the information and to return your phone call.  
Of course, we're partial to eMedTV for information about medications and breastfeeding. You can look up current information about breastfeeding for thousands of medications on our Web site. For each medication, we typically discuss a number of factors, including:
  • The manufacturer's recommendations
  • Any other official recommendations, such as from the American Academy of Pediatrics
  • Any research that has been done -- if the drug passes through breast milk, any side effects that were reported, etc.
  • Any other issues that might be important to a breastfeeding mother.
Another excellent resource is LactMed, a service from the National Institutes of Health. It provides very current and very detailed breastfeeding information about many drugs. We have yet to find a more comprehensive or more current resource for this type of information and, best of all, it's completely free. However, the information is sometimes highly technical and might be difficult for some moms to understand. You will also have to search using the drug's generic name rather than the brand name.
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