Drugs in Lactation

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

References:

1. Sachdeva S, Patel BG, Patel BK. Drug Use in Pregnancy: a point to ponder. Indian J Pharma Sci 2009; 71 (1): 1-7
2. KD Tripathi. Essentials of Medical Pharmacology 6th Edition