Medications that can have an adverse effect on your baby when you are breastfeeding
Some medications are not recommended, while others we do not know enough about as regards possible harmful effects for the baby.
Some medications pass easily into breastmilk, so that the baby ingests a lot of the medication while feeding. Examples of such medications:
- Lithium (used to treat bipolar disorder)
- Lamotrigine (used to treat epilepsy and bipolar disorder)
Some medications can affect the baby even though the amount of medication in the milk is very small. One example is chemotherapy drugs used in the treatment of cancer. Another example is ethylmorphine cough syrups such as Solvipect Comp and Cosylan, which should not be used by breastfeeding mothers. Other types of cough syrup are also not recommended for breastfeeding mothers.
Newborns most vulnerable to side effects
The risk of the baby experiencing side effects from medications passed through breastmilk is greatest in infants under two months of age. This is because newborns often excrete medication more slowly than older babies. This is especially true for babies that were born prematurely.
Over-the-counter medications that do not affect your baby when you are breastfeeding
Here are some examples of common over-the-counter medicines you can use while breastfeeding. The marketing name is shown in parentheses.
- Painkillers with the active substance paracetamol (Panodil, Paracet, Paracetamol and Pinex)
- Painkillers with the active substance ibuprofen (Ibuprofen, Ibumetin and Ibux)
- Painkillers with the active substance diclofenac (Voltarol, Voltaren)
- Nasal drops/nasal spray for nasal congestion with the active ingredients xylometazoline (Dexyl, Otrivin, Zymelin, Zycomb and Xylometazoline Hydrochloride) and oxymetazoline (Rhinox)
- Analgesic lozenges for sore throats with the active ingredient flurbiprofen (Strefen)
Breastfeeding mothers can be vaccinated
It is safe for mothers to have most vaccines while they are breastfeeding, with the possible exception of the yellow fever vaccine. Find out more about vaccines on the Norwegian Institute of Public Health's website (in Norwegian).
Sometimes we do not know enough to give a definitive answer
There will be cases where you and your GP will need to weigh up the benefits of breastfeeding against the risk of the medication affecting the baby.
This will be relevant if you take medication that could have adverse effects on the baby. It may also be necessary if you are taking a medicine that is new on the market. When it comes to new medications, we often do not know enough about how much medication passes into breastmilk and how it could affect the baby.
Discuss with your doctor what you should do. Here are some tips that could help reduce the amount of medication ingested by the baby while feeding:
- Combine breastfeeding with infant formula.
- Avoid breastfeeding when you have the most medication in your body (often soon after taking medication).
Your GP, public health nurse or pharmacist can advise you on this.
Useful sources of advice on medications and breastfeeding
Trygg Mammamedisin
At tryggmammamedisin.no you will find information about medicines and breastfeeding (in Norwegian). This is a free public service. Doctors and pharmacists answer questions over the phone or by email concerning how to use medicines when you are pregnant or breastfeeding. On the website, you will also be able to find information and advice on common ailments and how they can be treated safely.
GPs, health centres, pharmacies and other healthcare professionals
Your GP and health centre will be able to answer any questions you may have about taking medications while breastfeeding. You should talk to your doctor if you regularly take medications and are unsure or worried about possible harm to your child. When breastfeeding, you should consider the benefits and risks of taking medications. Your GP can refer you to a specialist if necessary.
Pharmacies have pharmacists who are knowledgeable about medications and can advise you on which medicines are safe to use during breastfeeding.
Felleskatalogen and package leaflets
Felleskatalogen (the Norwegian Pharmaceutical Product Compendium) and the package leaflet which you will find in the medicine packet have specific sections which describe use during pregnancy and breastfeeding. This information is prepared by the companies that manufacture the medicines.
Doctors and experts will sometimes tell you that it is OK to take a medication when breastfeeding, even if the packaging insert advises you not to. This is because healthcare professionals can provide individual advice based on the latest knowledge.
Due to the strict formal requirements, it can sometimes take time to update the text in Felleskatalogen and on packaging inserts.
Other useful sources of information about breastfeeding
- Information about breastfeeding and breast milk at Helsenorge (in Norwegian)
- Ammehjelpen (a service that provides advice and help with breastfeeding, in Norwegian)
- UNICEF’s brochures on breastfeeding in other languages (unicef.org.uk)
- The Norwegian Directorate of Health's guidelines for breastfeeding and infant nutrition (in Norwegian)