Safe and Harmful Drugs in Lactation

Nearly all drugs taken by the nursing mother are found in her milk though they may be present in too low concentrations to affect the baby.

Drugs considered safe during lactation

Some drugs considered safe during lactation are mentioned below. No adverse effects to the infant have been reported with the use of these drugs in normal doses.

Acetaminophen
Antacids
Inhaled corticosteroids
Insulin
Ibuprofen
Folic acid
Heparin
Lidocaine
Penicillins and Cephalosporins
Salbutamol
Thyroxine

Contraindicated during lactation

Some drugs contraindicated during lactation are mentioned below. If any of these drugs are considered crucial for the mother’s health, breast-feeding should be discontinued, as adverse effects can manifest in the baby, or lactation may be suppressed. Else, it is advisable to use an alternative drug for the condition being treated.

Anti-cancer drugs - cause diarrhea and reduced immunity in the fetus
Androgens – can affect sexual development of fetus and suppress milk production in the mother
Aspirin in large doses – May cause bleeding or Reye’s syndrome in the fetus
Chloramphenicol – Can cause diarrhea, bone marrow suppression and gray baby syndrome
Estrogens - May reduce milk production and cause increase breast size in male child
Ergotamine – May cause ergotism and suppress lactation
Iodine – Can cause low thyroid hormone levels and goiter in the baby
Lithium – Can cause abnormal heart rhythm
Metformin – Can cause low blood sugar and lactic acidosis in the baby