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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

How can I find out if it is safe to take a particular drug while nursing?

Taking an effective medication to improve a mother's health is important. Continued breastfeeding is important for baby's health. Health care providers must understand that both are important and that nursing moms and babies are a team. When mom needs a medication, her provider needs to be reminded that she is breastfeeding. Then it is important for the provider to prescribe a medication that is compatible with breastfeeding so that neither the mom's nor the baby's health will suffer.

Weaning is not necessary in most instances. Even if a particular medication is not compatible with breastfeeding, it is often possible to prescribe a different effective medication that is compatible. It is useful for mothers to discuss with their providers how important breastfeeding is to them.

Most medications are compatible with breastfeeding, but it is important to check to be sure. Sometimes the medication may be in the milk in such small amounts that it will not affect the baby. Sometimes by feeding first, and then taking the medication, the amount of medication in the milk is minimal before the baby feeds again. The age of the baby is also important, as a premature or newborn baby may be more affected by the medication than an older nursing baby.

The health care provider should use a reliable source for checking out this information. The PDR is a book most physician offices have, but it is really a compilation of the inserts from medications. Most inserts, for liability reasons, state that the medication should be used with caution in breastfeeding mothers. Therefore, this book is not a reliable guide for this purpose.

The American Academy of Pediatrics Committee on Drugs has published a list of medications that are compatible with breastfeeding. Most pediatricians and all La Leche League Leaders have access to this list and will share the information with mothers. More detailed information is available in a book, Medications and Mothers' Milk, by Thomas Hale, Ph.D. This useful book is updated yearly. All physicians or nurse practitioners who prescribe for mothers should have this book available for reference. It can be ordered on-line or by calling 800-378-1317. Most lactation consultants use this book on a daily basis to provide up-to-date assistance. Many La Leche League Leaders also have access to this book.

If you are taking an over-the-counter medication or herbal medications, it is also important to call and check on these. Many pharmacists are also helpful in providing useful information. One important thing to remember is -- if you are told you cannot breastfeed and take the medication, explore the reasons with your health care provider, and before taking a drastic step like weaning that will probably impact on your child's health, get a second opinion. Call your local breastfeeding support professionals. They may be able to share additional information with your physician.

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