Breastfeeding and Common Medications

Dr Krishna H Kumar, Obstetrician & Gynaecologist Specialist, Consultant for Byond28, and Past President of Obstetrical and Gynaecological Society of Malaysia (OGSM)

Breastfeeding is a critically important aspect of confinement. Breastfeeding provides the ideal nutrition for your baby’s healthy growth and development, whilst reducing the occurrence and severity of infectious diseases. However, there have been many questions posed regarding breastfeeding and whether a breastfeeding mother can still take medication.

Can a breastfeeding mother take medicine? While the summarised answer is usually yes, there is no guaranteed answer for this question. The American Academy of Pediatrics (AAP) released a report in 2013, which indicated most medication and immunisation are used safely with no adverse effects on breastfeeding. However, this does not mean that a mother can play doctor and self-medicate!

Keeping your doctor in the loop

The AAP have also recommended breastfeeding mothers to update their doctors on their pregnancy and illnesses. This will allow doctors to weigh the risks and benefits of the medication. Doctors will be able to make an informed decision to consider whether the medication is necessary or not. Advice usually include:

· The potential effects the medication may have on breast milk production

· How much the medication may transfer to your baby through your breastmilk

· Any potential adverse effects of your illness on your baby

There is always a possibility of medication passing through breast milk and will collect in the baby’s body. Whether this will happen, and the extent of its effectiveness, all depends on the baby’s metabolism rate and the duration the medication is taken. Antibiotics are a common medication, and some amount will be transferred to your baby through breast milk. Allergy medication may decrease breast milk production and cause lethargy and irritation to infants.

Although herbal products are generally safe for consumption during breastfeeding, mothers should make sure that they are from a reputable source. Certain herbal ingredients contain alkaloids that could potentially harm babies. It is important to keep your doctor notified on the status of your pregnancy and lactation.

Generally safe-to-use medication during breastfeeding include:

· Certain painkillers (Acetaminophen, Ibuprofen)

· Some antibiotics (Fluconazole, Penicillin – such as amoxicillin an ampicillin)

· Antihistamines (Loratadine, Fexofenadine)

General medication to avoid during breastfeeding include:

· Anticancer drugs

· Radioactive pharmaceuticals

· Amiodarone (a type of heart medication)

· Chloramphenicol (a type of antibiotic)

· Ergotamine (used to treat headaches, e.g. migraine)

· Gold sodium thiomalate (a type of gold salt used for rheumatoid arthritis)

· Phenindione (an anticoagulant)

· Retinoids (used to treat skin problems)

· Tetracyclines (a type of antibiotic)

· Psychotropic medications

When In Doubt

It is important to always check with your doctor whenever you decide to take any medication yourself. Avoid taking unnecessary medication, high-dose vitamins, and unusual supplements. Pay attention for any signs or adverse symptoms that your baby may display, such as change in eating or sleeping habits, or rashes in unusual locations. When in doubt, stop taking your medication and immediately consult your doctor.

An educational collaboration with Obstetrical and Gynaecological Society of Malaysia

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