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Quick reference medical handouts used by Pediatric offices

Drugs and Other Substances in Breast Milk

During the last two decades there has been a marked increase in breast-feeding by American mothers. Breast milk is the optimal food for the newborn and young infant, yet breast-fed babies may be exposed to a number of dangerous substances in mother's milk. These include medicines (both prescription and over-the-counter), illicit drugs, environmental contaminants, and infectious agents. Some of these substances may be found in breast milk in quantities high enough to cause harm to the infant.

Because there are many factors that determine whether a medication or other substance can reach harmful levels in the breast-fed infant, mothers who are breast-feeding should avoid any unnecessary exposure to drugs or other chemicals.

Medications such as aspirin, Tylenol, most antibiotics, and antihistamines (allergy and cold preparations) appear to be safe when taken while breast-feeding. Some caution needs to be used when laxatives, asthma medications containing theophylline, and sedatives (e.g., Valium and phenobarbital) are ingested by breast-feeding mothers.

Substances such as alcohol and caffeine are safe if taken in small amounts. Recent studies have shown the harmful effects of nicotine in breast milk so mothers who smoke and breast feed are placing their newborn at increased risk for a number of serious medical problems.

Many commonly used prescription medications have been shown to be harmful to the breast-fed infant. These medications should be avoided if possible. If they can t be avoided for medical reasons, breast-feeding should be temporarily discontinued. These medications include: atropine, drugs for hyperthyroidism, cancer chemotherapy, tetracyclines, chloramphenicol, iodides, reserpine, narcotics, lithium, radioactive preparations, and ergot preparations. Prolonged use of steroids, oral contraceptives (birth control pills), sedatives, diuretics (water pills), and anti-seizure medications should only be done under direct supervision of a physician. Your physician should always be informed that you are breast-feeding whenever medications are prescribed.

Environmental pollutants are substances found in breast milk are usually not harmful. In addition, efforts of environmentalists have resulted in decreasing environmental levels—and consequently, decreasing breast-milk levels—of many environmental pollutants, such as DDT and dieldrin are unavoidable, and many can be detected in human milk as well as in cow s milk and infant formulas. Pesticides, organic mercury, and lead are the pollutants that cause the most concern.  Environmental pollutants should only be of concern when environmental levels of pollutants are unusually high.

Only rarely will the medical needs of the mother cause any concern about the safety of the breast milk for her infant. Consultation with a physician is reasonable before the breast-feeding woman takes any medication (prescription or non-prescription). A simple guide is that the breast-feeding mother should not take any drug that she would be reluctant to give directly to her infant.


As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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