Medications and Breast-Feeding: Current Concepts
Classes of OTC medications that are commonly used by breast-feeding women include analgesics; cough, cold, and allergy preparations (including lozenges, inhalers, drops, rubs, sprays, and nasal preparations); asthma preparations; antacids and digestive aids; laxatives and stool softeners; antidiarrheal preparations; nausea, vomiting, and motion sickness preparations; hemorrhoidal preparations; sleep preparations; stimulants; appetite suppressants; insulin preparations; artificial sweeteners; oral hygiene products; heart attack risk reduction medications; pinworm treatments; smoking aids; vaginal infection products; eye and ear medications; and a wide variety of topical formulations. In most cases, ingredients of eye, ear, and topical OTC preparations should not appear in breast milk in harmful quantities. If skin preparations are required for sore or cracked nipples, care creams specific for this condition should be used. Vitamins and minerals in daily recommended doses are safe for nursing mothers to take.
In many cases, OTC medications consist of multiple ingredients for multiple symptoms. Many OTC products have both regular- and extra-strength forms. In addition, medications may be short or long acting. There are OTCs that have the same root name for multiple formulations. For example, Maalox Total Relief includes bismuth subsalicylate and Maalox Maximum Strength has three active ingredients (aluminum hydroxide, magnesium hydroxide, and simethicone).
To help mothers make informed decisions regarding OTC product use during breast-feeding, the following counseling guidelines are offered:
OTC Medications
Classes of OTC medications that are commonly used by breast-feeding women include analgesics; cough, cold, and allergy preparations (including lozenges, inhalers, drops, rubs, sprays, and nasal preparations); asthma preparations; antacids and digestive aids; laxatives and stool softeners; antidiarrheal preparations; nausea, vomiting, and motion sickness preparations; hemorrhoidal preparations; sleep preparations; stimulants; appetite suppressants; insulin preparations; artificial sweeteners; oral hygiene products; heart attack risk reduction medications; pinworm treatments; smoking aids; vaginal infection products; eye and ear medications; and a wide variety of topical formulations. In most cases, ingredients of eye, ear, and topical OTC preparations should not appear in breast milk in harmful quantities. If skin preparations are required for sore or cracked nipples, care creams specific for this condition should be used. Vitamins and minerals in daily recommended doses are safe for nursing mothers to take.
In many cases, OTC medications consist of multiple ingredients for multiple symptoms. Many OTC products have both regular- and extra-strength forms. In addition, medications may be short or long acting. There are OTCs that have the same root name for multiple formulations. For example, Maalox Total Relief includes bismuth subsalicylate and Maalox Maximum Strength has three active ingredients (aluminum hydroxide, magnesium hydroxide, and simethicone).
To help mothers make informed decisions regarding OTC product use during breast-feeding, the following counseling guidelines are offered:
Avoid taking OTC products for which little breast-feeding information is available. Pharmacists should be able to provide additional information.
Avoid taking OTC products for which safer products are available. Pharmacists should be able to help determine alternatives.
Avoid taking combination OTC products, which are those with multiple ingredients. It is better for mothers to take OTCs that have the one or two specific ingredients that will treat a specific condition; mothers or breast-feeding infants should not be exposed to unnecessary ingredients.
Avoid taking extra-strength forms of OTC products. Again, breast-feeding infants should not be exposed to higher levels of a drug.
Avoid taking long-acting OTC products. Infants should not be exposed to a drug for longer than necessary, especially if an adverse reaction is possible.
Mothers should know the exact OTC ingredient(s) and possible adverse effects that might occur in infants and themselves. Pharmacists can advise.
If possible, mothers should first use nondrug approaches to treat symptoms.
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