Medicines and breastfeeding

Many medicines are safe to take while breastfeeding — only a very small amount of these medicines passes into your breast milk, and is rarely harmful to your baby.

Always check with your doctor or pharmacist to see if your medicines are safe to use while breastfeeding, or if you are thinking of making any changes to them. This includes both prescription and over-the-counter medicines.

Some medicines can cause your baby to have diarrhoea or make them sleepy or irritable. Other medicines can change your breast milk supply.

The amount of medicine that enters your breast milk and the effect on your baby depends on:

• the type of medicine
• the dose you take
• when you take it

Allergy and hay fever medicines: antihistamines that do not make you sleepy are considered safe while breastfeeding. Nasal sprays and eye drops are safe. Antihistamines that make you sleepy are not recommended because they may make your baby sleepy.

Antibiotics: most antibiotics used to treat bacterial infections are safe, but always follow your doctor's advice. Tetracyclines (such as doxycycline) may be used short term. Metronidazole can make your breast milk taste bitter.

Antidepressants: most antidepressants are safe while breastfeeding. Talk with your doctor.

Asthma medicines: most preventers and relievers are safe. It's very important that you do not stop your asthma medicines while you are breastfeeding. If you are taking high doses of steroids (such as prednisolone) or using them for long periods of time, speak with your doctor — it is recommended to wait 4 hours after a dose before breastfeeding.

Cold and flu medicine: it's best to use saline nasal sprays and decongestant nasal sprays. Medicines containing pseudoephedrine may reduce milk supply.

Cough medicines: Some cough medicines contain codeine. Codeine should not be used while breastfeeding. Ask your pharmacist to suggest a suitable cough syrup.

Oral contraceptives (the pill): the progesterone-only mini pill is best while breastfeeding. The pill (combined oral contraceptive pill) should not be taken.

Pain relievers: paracetamol and ibuprofen are safe to take at the recommended dose while breastfeeding. Avoid taking aspirin for pain relief, but your doctor may prescribe it for another health condition.

Worm treatments: most worm treatments are safe to take when breastfeeding.

Sore throat medicines: A saltwater gargle or drinking lemon and honey may also ease a sore throat.

Avoid gargles containing povidone-iodine.

What if I need a vaccination?

Most vaccinations are safe and effective while you are breastfeeding.

You can continue to breastfeed after you get the flu (influenza) vaccine.

Yellow fever vaccination should only be given if needed.

Always tell your doctor if you are pregnant, plan on becoming pregnant or breastfeeding before receiving a vaccine.

Ask your doctor about ways to reduce the amount of medicine that goes into your breast milk.

It may be possible to:

• take a lower dose of your medicine
• take it for a shorter time
• take a quicker acting form of medicine

The amount of medicine in your body is lowest just before you take your next dose. This is a good time to feed your baby.

For most medicines, there is no need to express and throw away your milk (sometimes known as 'pump and dump').

When taking any medicine, watch for signs of possible side effects in your baby. These may include:

• being more sleepy or irritable than usual
• feeding problems
• diarrhoea
• vomiting
• allergic reactions

If your baby is under 2 months of age, they may have a higher chance of side effects from your medicines. Make sure to watch them carefully.

Rarely, you may be advised to stop breastfeeding while you are taking some medicines, in case they harm your baby.

Examples of medicines that are not suitable while you are breastfeeding are:

• some anti-cancer drugs
• lithium for some mental health problems
• injectable medicines used during some scans

In these cases, you can express and throw away your milk, to keep up your milk supply until it is safe to breastfeed again. Speak to your doctor or pharmacist for specific advice on when it is safe to breastfeed your baby.

Complementary medicines, including vitamin and mineral supplements, herbal preparations and natural medicines, may also have risks for your baby.

Some vitamins and minerals are recommended for all people who are breastfeeding. This includes a daily iodine supplement. Supplements such as calcium and vitamin B12 can be taken if you do not have enough in your regular diet.

You should talk to your doctor or midwife before taking herbal medicine or tea.

Like other medicines, complementary medicines can:

• have side effects
• cause allergic reactions
• interact with your prescription medicines

With most herbal and traditional medicines, there is not enough research to check their safety when breastfeeding. It's always best to ask your health professional for advice.

To check the safety of your medicines you can talk with:

• your doctor or pharmacist
• the Poisons Information Centre — phone the Poison Information Hotline on 13 11 26
• a pharmacist at 1300 MEDICINE — phone 1300 633 424

For help and advice with breastfeeding you can talk with:

• your midwife or child health nurse
• the Australian Breastfeeding Association Breastfeeding Helpline on 1800 686 268 (1800 mum 2 mum)

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

The Australian Breastfeeding Association has booklets on Breastfeeding Confidence available in many community languages.

They also have a video on How Breastfeeding Works available in Arabic and Chinese (simplified).

Information for Aboriginal and/or Torres Strait Islander peoples

The Australian Government has a booklet about breastfeeding for Aboriginal and Torres Strait Islander peoples.

The Queensland Government has a booklet available — Breastfeeding: good for Baby, good for Mum.

The Australian Breastfeeding Association has a resource page on breastfeeding for First Nations people.