June 11, 2019

After my daughter was born, there were of course many joyful moments, some big and some small. Initially, one of the greatest joys for me was not being pregnant anymore and the relief of not having to worry as much about what I ate and drank, what face wash I used, and how every other chemical I was around would affect her health and development. I was so looking forward to getting back to my favorite foods and carefree ways. In fact, the first time my husband and I brought my newborn daughter in public it was to a sushi restaurant for my first post-pregnancy helping of raw fish.

However, the concern over what is safe during pregnancy was quickly replaced by another concern, what is safe for breastfeeding. Luckily this list of no-nos is a lot smaller than for pregnancy, and I was fortunate that she didn’t have gas or acid reflux issues, so I didn’t have to restrict my diet. For me, the biggest concern was medicine.

Have you ever noticed that pretty much all the labels on over-the-counter medications say that if you’re breastfeeding, to talk to a health professional? In a perfect world, we would all have doctors at our disposal that are familiar with all the breastfeeding research. But I personally hesitated to call my doctor every time I got a headache or allergies or upset stomach, and would just go without if I wasn’t sure or couldn’t remember.

Luckily, you don’t have to suffer through symptoms or feel like you’re pestering anyone. It turns out there are tools available that you can trust to see if medication is safe for breastfeeding (if you’re still unsure, don’t feel bad about calling your doctor).

LactMed - One of the most trusted resources is called LactMed and its part of the National Library of Medicine's (NLM) Toxicology Data Network. It presents a summary of the studies (and also includes all of the studies and risks if you’re into that), which tells you what the risks are.

For example, if you look up pseudoephedrine (marketed as Sudafed), here’s the summary:

Summary of Use during Lactation:
Although the small amounts of pseudoephedrine in breastmilk are unlikely to harm the nursing infant, it may cause irritability occasionally. A single dose of pseudoephedrine decreases milk production acutely and repeated use seems to interfere with lactation. Mothers with newborns whose lactation is not yet well established or in mothers who are having difficulties producing sufficient milk should not receive pseudoephedrine. A treatment scheme has been reported for mothers with hypergalactia that uses pseudoephedrine to decrease milk supply.

MotherToBaby - MotherToBaby is a service provided by the non-profit Organization of Teratology Information Specialists (OTIS). It has fact sheets on a lot of common medications and other exposures, with FAQs. There’s a lot of info there, too, but it tends to be a little more readable to the average person.

Both of these resources have prescription and OTC meds, but they’re not meant to replace a convo with your doctor (although they are probably more reliable than Dr. Google). If you’re considering prescription meds, you should definitely talk to your doctor about whether they’re safe for breastfeeding (technically, you should with over-the-counter meds, too). If not, there may be alternatives that are safer.

As with all health and medical treatments, there are going to be risks with any course of action, so the best thing you can do is try to understand them, weigh them against the benefits, and make an informed decision. Please keep in mind that sometimes the benefits of taking a medication are worth pausing or ending breastfeeding. Your health is important!