Nursing mothers: how to use medicines safely while breastfeeding

Worried a prescription or OTC drug might harm your baby? You're not alone. Many new parents face this and the good news: most medicines can be used while breastfeeding if you check a few things first. This guide gives clear, practical steps you can use right now.

Quick checks before you take a medication

First, look it up in a trusted source like LactMed or the InfantRisk Center. Then ask the prescriber or pharmacist: can this be swapped for a safer option? Ask about dose, timing, and how long you'll need it. If the answer is unclear, call your baby's pediatrician to see what signs to watch for.

Think about timing. For drugs that peak in your blood a few hours after a dose, consider taking them right after a feed or before a long sleep so levels fall before the next feeding. Use the lowest effective dose for the shortest time possible. Keep a note of what you take and when, so you can report it if your baby changes behavior.

Common drugs nursing mothers ask about

Acetaminophen and ibuprofen: These are commonly used for pain and fever and are usually considered safe in normal doses. They rarely cause problems in breastfed babies.

Antibiotics: Many antibiotics (amoxicillin, azithromycin, cephalosporins) are fine while breastfeeding. Some classes—like tetracyclines—are usually avoided in infants, so ask before you start.

Sleep and anxiety meds: Avoid strong sedatives when possible. Short courses of certain benzodiazepines can be used but ask your doctor. Watch for drowsiness or poor feeding in the baby.

Pain meds: Avoid routine use of codeine or tramadol because some people metabolize them very fast and pass higher levels into milk. If you need stronger pain control, talk to your provider about alternatives and monitoring.

Decongestants and antihistamines: Pseudoephedrine and first-generation antihistamines can reduce milk supply in some people. If milk production is a concern, try alternatives like saline sprays or non-drowsy antihistamines after checking with your clinician.

Antidepressants: Untreated depression affects both you and your baby. Many SSRIs—sertraline is commonly chosen—are used during breastfeeding. Discuss risks and benefits with your prescriber before stopping or changing therapy.

Herbal supplements: Most lack good data for nursing. Don’t assume 'natural' means safe. Ask a pharmacist and avoid long-term use of unproven products.

Pumping and "dumping": Rarely needed. Most medicines don't require you to discard milk. Your provider will tell you if a drug is an exception and how long to wait.

Watch your baby for changes: unusual sleepiness, poor feeding, rash, diarrhea, or breathing problems. If any of these happen after you start a drug, call your pediatrician.

Bottom line: you can usually take medicines while breastfeeding, but check resources, ask professionals, and watch your baby. That small extra step keeps both of you safer and lets you focus on care and recovery.