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Breastfeeding

Breastfeeding and medication

Some women cannot breastfeed because of their medication. Fortunately those cases are rare. Explanation and recommendations.

A breastfed child receives at most 1% of his mother’s dose when she uses oral medication. It is rarely recommended to avoid or stop breastfeeding, according to Caroline Morin and Ema Ferreira, pharmacists and researchers at the Research Centre of the CHU Ste-Justine.

Nevertheless, some drugs raise concern and that is why, for each patient, the doctor and pharmacist must take many factors into account before pronouncing their verdict.

Cons-indication: factors involved
  • The dose ingested by the baby
    The medication should not cause adverse effects if the amount to which the child is exposed is less than 10% of the pediatric dose. Pharmacists determine this amount by taking many factors into account such as the child’s weight. The pediatric dose is the dose that would be prescribed to the child if he took the drug for himself.
  • The ability of the baby’s body to maintain some internal characteristics (such as his temperature)
  • The toxicity of the drug
  • The age of the baby

Much of the antibodies are transmitted to the baby through breast milk during the first phase of breastfeeding. As the quantity of substances and nutrients coming directly from the mother is more important during this period, it is also the moment when your baby will be most exposed to the proteins of the drugs.

  • The number of feedings and the average quantity consumed by the baby
  • The prematurity of the baby
  • The mother’s health
  • The frequency of the drug intake
Likely side effects of medication during breastfeeding

There are very few studies on the long-term side effects of medication in breastfeeding women because the information is difficult to gather, says Ema Ferreira, who is also a teacher at the Université de Montréal.

However, we know that some drugs can disrupt the production of milk, either by reducing the production or ejection or by increasing it.

Other adverse reactions may include behavioural problems (lethargy, drowsiness, irritability, constant crying) and eating disorders (insufficient sucking, digestive problems) combined with slower weight gain, skin rash and increase risk of infections.

The medication cannot be addictive in children except if the mother consumes methadone (a heroin substitute prescribed during withdrawal) during pregnancy: the baby could experience methadone withdrawal.

Over the counter and safe medicine

  • Aspirin: must be taken moderately
  • Ibuprofen (Advil for example) and other anti-inflammatory drugs
  • Pain relievers (Tylenol for example).
  • Antihistamines (against allergies): Claritin brand is not cons-indicated but it is best to consult a pharmacist before choosing a brand.
  • Antitussive (Cough and sore throat syrups).
  • Drugs that relieve nasal congestion: some may decrease milk production.
  • Birth pill: could decrease the production of milk if taken too early after childbirth.

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