Medication use during breastfeeding

It has long been accepted by pediatricians that mother’s own milk is the best form of nutrition for an infant. When comparing breast milk to formula, most studies show a significant benefit to breast feeding. The American Academy of Pediatrics recommends that mothers exclusively breastfeed their babies for about six months, then introduce food while continuing to breastfeed until twelve months, and that breastfeeding should be continued after that as long as both mother and baby are interested.

There have been many benefits to breastfeeding found in studies comparing it to formula feeding. Breast milk is packed with antibodies from the mother, which help protect the baby from infections, illnesses, and allergies. The incidence of SIDS is also lower, the rate of neurodevelopment is faster, and the prevalence of infection is lower in infants who are breastfed when compared to those who are formula fed. The American Academy of Pediatrics states that “choosing to breastfeed should be considered an investment in the short- and long-term health of the infant, rather than a lifestyle choice.”

There are many reasons why women think that they cannot breastfeed, but most of the reasons stated are not true contraindications to breastfeeding. Some mothers think that since they smoke they cannot breastfeed, but this is not exactly true. Although mothers should be encouraged to quit smoking while they are breastfeeding a child, the benefits of breast milk are still enough to outweigh the risks of the baby’s exposure to nicotine. Other mothers might think that since they are on a chronic medication, such as an antidepressant, that they cannot breastfeed, but this is also a false presumption.  In reality, women can breastfeed safely while using most medications, but not all. Most medications due pass into the breast milk, but it is in such small amounts that there is not likely a pharmacodynamics effect on the infant. The American Academy of Pediatrics states that contraindication to breastfeeding are rare. All clinicians counseling a patient on the use of medications during breastfeeding should consult the most up-to-date resources and use these in combination with clinical experience to decide whether a medication is safe during breastfeeding.

Alexis Ireland, PharmD Candidate 2014

References

"Breastfeeding and the Use of Human Milk." Pediatrics 129 (2012): 826-42.

Rowe, Hilary, BSc(Pharm), et. al. "Maternal Medication, Drug Use, and Breastfeeding." Pediatr Clin N Am 60 (2013): 275-94.