Medications and breastfeeding: which ones are safe to take?

Why certain medications should not be taken if you are breastfeeding? 

Some medications are not recommended for breastfeeding women because of the risks they present to the baby. These risks fall into three main categories:

1/ Drugs that are toxic for baby 

Some medicines can pass into breast milk in significant quantities and cause undesirable effects in the baby. For example, antibiotics can cause digestive problems or affect the child's dental development. In another example, drugs used to treat mental disorders in the mother can induce drowsiness or lethargy in the baby.

2/ Drugs that affect lactation 

Certain treatments can reduce milk production. For example, bromocriptine, a dopamine agonist for Parkinson's disease (Parlodel®), and cabergoline (Cabergoline, Dostinex®), prescribed for the symptomatic treatment of hyperprolactinaemia, slow down the release of prolactin, a hormone essential for milk production.

3/ Drugs that are difficult to eliminate due to immaturity of the baby's organism 

As the liver and kidneys of newborns are still developing, some drugs are eliminated more slowly, which can lead to their accumulation and increase the risk of toxic effects. This is the case with non-steroidal anti-inflammatory drugs (NSAIDs) such as Diclofenac, Celebrex® or Nurofen®.

Before taking any medication, breast-feeding mothers must consult a health professional to assess the benefits and risks for their child.

What medications can you take while breastfeeding? 

When breastfeeding, many medicines are considered safe for both mother and baby.
Here is a list of the most commonly used:

Pain killers and anti-fever medication 

Paracetamol and ibuprofen are widely recommended for relieving pain and fever in breastfeeding mothers. Their passage into breast milk is minimal, making them compatible with breast-feeding.  

Antibiotics 

Antibiotics such as amoxicillin, penicillins and cephalosporins, a class of β-lactam antibiotics (Alfatil®, Cefixime), are generally considered safe during breastfeeding. They are commonly prescribed to treat a variety of bacterial infections.

Antihistamins 

To treat allergies, non-sedating antihistamines such as loratadine and cetirizine are preferred, as they present a low risk of drowsiness for infants.

Some drugs for certain chronic conditions 

Some treatments for conditions such as high blood pressure, diabetes or thyroid problems are compatible with breastfeeding. However, a medical assessment with your GP is necessary for each individual case!

What medications cannot or should not be taken while breastfeeding? 

When breast-feeding, certain medicines are not recommended or prohibited because of the risks they may pose to the baby.
Here is a list of the main categories of medicines to avoid:

Opioids

Codeine and tramadol are generally not recommended during breastfeeding due to the risk of respiratory depression in infants. They should only be used on medical advice, for a very short period (2 to 3 days) and at the lowest possible dosage.

Antidepressants and anti-anxiety medication

Certain selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine, and benzodiazepines such as diazepam, can cause drowsiness, lethargy and slowed weight gain in infants. It is therefore recommended that they be avoided or used with extreme caution under medical supervision.

Oral decongestants 

Medicines containing pseudoephedrine (Actifed®, Dolirhume®), used to relieve nasal congestion, can significantly reduce milk production by lowering prolactin levels. Their use is therefore not recommended during breast-feeding.

Over-the-counter medicine 

Cough syrups, anti-inflammatories or natural remedies can be harmful to babies.

What can you do if your medication is incompatible with breastfeeding? 

When a medicine is incompatible with breastfeeding but is still essential for the mother's health, there are several solutions that allow the treatment to continue while protecting the baby.
Many medicines have safe equivalents for breastfeeding. For example, in the event of pain, paracetamol is often preferred to other, more powerful painkillers. However, a doctor or pharmacist can also advise you on the best options for each situation.
If no alternative is available, it may be advisable to take the medicine immediately after a feed. This method limits the presence of the drug in breast milk at the time of the next feed, thereby reducing the infant's exposure.

In cases where no adjustment is possible, a temporary break in breastfeeding may be considered.
In addition, before starting treatment, it is advisable to express and store breast milk to ensure that the baby is fed during this period. A final word of advice: to avoid a drop in lactation, mums should continue to stimulate milk production by expressing regularly.

À retenir ! 

Breastfeeding and taking medication are not incompatible, provided you are well informed. Many treatments are harmless, and if in doubt, there are always alternatives.
If you are being treated for a chronic illness or if you become ill while breastfeeding, talk to a health professional before taking any medication. Don't let uncertainty spoil the moment with your baby!

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