When can you continue to breastfeed?
You can breastfeed if
- none or very little of the medication passes into breastmilk.
- long-term experience of breastfeeding mothers using the medication has been documented without any harmful effects on the baby.
- the medication is quickly destroyed in the baby’s stomach and intestines (examples include insulin taken for diabetes and heparin taken for blood clots).
Over the counter medications
Examples of common over the counter medications that can be used by breastfeeding mothers (trade names 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)
- Nasal drops/nasal spray for nasal congestion with the active ingredients xylometazoline (Dexyl, Otrivin, Zymelin, Zycomb and Xylometazoline Hydrochloride) and oxymetazoline (Rhinox).
Medications that can have an adverse effect on the baby
Some medications pass easily into breastmilk so that the baby ingests a lot of the medication while feeding. Examples of such medications include
- 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.
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.
Sometimes we know too little to give a definite answer
There will be cases in which 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 can have adverse effects on the baby in rare cases or if you are using a medication that is new. When it comes to new medications, we often know too little about how much medication passes into breastmilk and how it could affect the baby.
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.
Advice from Trygg Mammamedisin
Trygg Mammamedisin is a free, public service in which doctors and pharmacists answer questions relating to the use of medication during pregnancy and breastfeeding.
You can submit your questions via the tryggmammamedisin.no website (in Norwegian). You will also be able to find information and advice on common ailments and the safe treatment of these on the website.
Sometimes the doctors and experts at Trygg Mammamedisin will tell you that it is OK to take a medication when breastfeeding even if the packaging insert discourages you from doing so. This is because the doctors and experts at Trygg Mammamedisin are able to provide individual advice based on new research. Due to the strict formal requirements, it can sometimes take time to update the text on packaging inserts.