Prescription Drugs And Breastfeeding: What You Should Know

Many prescription drugs are secreted in the breast milk in significant quantities. In such cases, whether breastfeeding should be continued by the mother or not is an important decision that needs to be taken by a medical expert, taking into account the benefits of breastfeeding and adverse consequences of unintended medication of the child.  
Prescription Drugs and Breastfeeding: What You Should Know
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Prescription Drugs can be secreted in mother’s milk and thereby affect a child. Understanding this simple fact can help one take all the precautions to ensure that prescription drugs taken by the mother do not adversely affect the health of the child. It is a decision to be taken by the physician, but the mother must bring it to the notice of the physician.


Mother's milk is the best nutrition for the infant. However, when the mother is taking some prescription drugs, her milk may contain those medications and the young infant will also have to endure them. The drugs that

are safe for an adult are not always equally safe for a newborn child because of her limited capacity to detoxify and excrete such drugs. Thus, one needs to be aware about the drugs that can be secreted in milk and enter the child's body.

Factors that Affect the Safety of Using a Medication during Breastfeeding

Not all medications are equally safe or harmful when used by a breastfeeding mother. Their safety or risk depends on a number of factors. The first of them is the age and health of the child. A premature child or a child having some disease, especially related with kidneys is at greater risk, and so requires greater precaution - even comparatively safe medicines need to be avoided to the extent possible.

The second factor that affects safety is the quantity of that drug secreted in milk. Some drugs are either not secreted in milk or secreted in such minute doses that they are unlikely to have any effect and so are considered safe. Other drugs are secreted in a greater proportion and need caution. Third factor is the duration of the action of medicines - drugs that are short acting would be safer, and their safety can also be improved by timing their intake to avoid peak concentrations during breast feeding. Last factor is the effect that the drug could have on children. For example, Aspirin can lead to a condition called 'Reye's Syndrome' in children, so it is better to avoid it. Tetracycline can stain the teeth, hence is better avoided.

Assessing the Need vs. Risk of using Medications during Pregnancy

The need for using a prescription drug to treat the mother's illness needs to be considered against the risk caused to the child. It is an expert's job and so should be done only by the prescribing physician.  As a rule, in minor and self limiting conditions, medications should be avoided. If it is

possible to treat the condition with topical drugs, they should be preferred over oral medication - as in case of topical anti-fungals and topical analgesics.

Categorisation of Drugs According to Risk to Child

Prescription drugs are categorised in different categories on the basis of their risk to child during breastfeeding. Broadly speaking, there are three categories - SAFE, which can generally be used in breastfeeding; REQUIRING CAUTION, which can be used during breastfeeding but only as per advise of physician and the child should also be kept on watch for any side effects; and CONTRAINDICATED, which should always be avoided during breastfeeding.

For example, among antipyretic medicines used to treat fever, IBUPROFEN is considered safe, most other require caution, while ASPIRIN is contraindicated.

Choice of Prescription Drug in Breastfeeding Mother

The physician, when prescribing drugs to a breastfeeding mother will usually consider all the factors above, and try to select a drug which takes care of the mother's illness with least risk to the child fed on her milk. He may also minimise the dose, time it to further reduce the dose in milk or opt for a combination therapy whereby dose of each drug is reduced further to make it safe. Sometimes, non-drug therapies like surgery may be preferred due to these factors.

Precautions for the Breastfeeding Mother

A breastfeeding mother must take certain precautions to ensure maximum safety for the child. The physician prescribing the medication must be told the complete medical history of the child. If during the period of medication, any change in child's behavior or health is observed, it must be brought to the notice of the physician prescribing drugs to mother. Similarly, the drug history of mother should be shared with paediatrician taking care of the child's health and ailments.

While the safety of prescription drugs is taken care of by the physician, one must not forget to remember these principles in case of OTC drugs as well as alternate therapies used during breastfeeding. They can also get secreted in milk and potentially affect the child.

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