Unsafe Medications during Breast Feeding
Which medicines are safe for nursing mothers? What are the side effects of commonly prescribed medicines? How to avoid these side effects? These are very commonly asked questions by nursing moms. The effects of all medicines affecting baby depends on type, dose, intake route, amount passed breast milk and amount of milk intake by baby.
The purpose of this blog is to guide about safe and unsafe medicines during breast feeding and to avoid problems associated with it.
Which medicines do not pass breast milk?
Epinephrine, heparin, and insulin do not cross in breast milk.
Which medicines can be safely used?
These are local inhalers, steroid creams, nasal and eye drops, painkiller rubs, anti-lice shampoos, local skin creams for various diseases and fungal infections.
Which antibiotics are safe to use?
All penicillin’s (ampicillin, amoxycillin, co-amoxiclav, flucloxacillin), and cephalosporins (cefaclor, cefalexin, cefradin, cefuroxime) can be safely used but macrolide (erythromycin, azithromycin) should be used with caution.
Which anti-allergy medicines are safe?
Non-sedating anti-allergy medicines like loratadine, cetirizine, antihistamines and mild steroids in forms of sprays and drops are safe. Try to avoid sedating (sleep inducing) anti-allergy medicines like chlorpheniramine.
Are painkiller medicines safe?
These are usually paracetamol or other non-steroidal anti-inflammatory drugs which are taken orally or locally, these are safe to use. But try to avoid opioid analgesics like codeine and its derivatives.
Are decongestant medicines safe?
Local sprays or drops are safe but oral anti-congesting medicines can reduce milk supply.
Which medicines should be avoided during breast feeding?
There are medicines which are secreted in milk, and they should be avoided as they are harmful for baby. These are Chemotherapy agents, amphetamines, chloramphenicol, ergot, lithium, sulpha drugs, amiodarone, iodide, gold salts, illicit drugs like cocaine, heroin, phencyclidine and radioactive contrasts used for diagnostic radiology.
Which antibiotics should be avoided?
Antibiotics with sulpha group (sulphapyridine, sulphisoxazole) should be avoided in premature, sick, stressed, and jaundiced babies as they can cause vomiting, jaundice, bloody diarrhea and life-threatening blood changes (red cell break down in enzyme deficiencies of G6PD).
What are side effects of Anti-anxiety medicines or sleeping pills?
Benzodiazepines can cause irritable baby, excessive crying, vomiting, jaundice, excessive sleep, slow heart rate and shallow breathing.
How anti-depressants effect baby?
These are commonly prescribed medicines like tricyclic anti-depressants. SSRI serotonin reuptake inhibitors can cause sleep and feeding problems in baby, colic, and growth restriction.
What are side effects of anti-psychotic medicines?
They make baby drowsy, irritable, and slow growth and development.
Can a mother on chemotherapy breast feed her baby?
Anticancer drugs, methotrexate, cyclophosphamide, cyclosporin, doxorubicin is secreted in milk and can suppress baby’s immunity, low blood cell count, impair growth and increase chances of cancers.
How safe are blood thinners for nursing moms?
Heparin is not excreted in breast milk; higher doses of warfarin can increase bleeding tendency in baby.
What are side effects of oral contraceptive pills on new-born?
Estrogen hormone (Estradiol) can cause with-drawl bleeding in female babies, therefore only low dose pills are recommended after doctor consultation.
Is aspirin dangerous for nursing mothers?
If mother takes it in larger amount, then it can cause diarrhea, vomiting and jaundice in newborn.
What are side effects of anti-arrhythmic medicines?
Amiodarone commonly used to treat and prevent irregular heart beat patterns can suppress thyroid of baby resulting in hypothyroidism.
Could all high blood pressure lowering medicines be given?
Beta blockers (atenolol, acebutolol) can lower blood pressure, depress breathing and slow heartbeat of baby, and can cause blue discoloration of skin (cyanosis) due to decreased blood supply.
How safe are migraine medicine?
Sometimes (ergot) migraine medicine become extremely dangerous for baby causing vomiting, diarrhea, fits and life-threatening seizures.
Are there any eye drops which are dangerous for nursing mothers?
Chloramphenicol is used to treat eye infections, but if it is used without doctor supervision for prolong can cause bone marrow suppression of baby (aplastic anemia).
How anti leprosy medicine clofazimine effects baby?
It can cause pigment loss from skin and discoloration.
What are effects of excessive caffeine on baby?
It can make baby very irritable, excessive crying or difficulty in sleeping.
How smoking effects baby?
Nursing mothers should not smoke as it reduces milk production and slows growth of baby, for those who smoke, should not feed till 2 hours of smoking.
How can side effects of drugs be minimized?
This can be overcome by adjusting dose of medicine, limiting time of use, taking it immediately after feeding or in the longest interval between feeds.
REMEMBER! All nursing mothers should always consult a health practitioner before taking any drug herbal or over the counter sale medicines for avoiding any side effects on mother and baby.
Dr. Ayesha Azam Khan