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Women's Health Information: Royal Women's Hospital, Melbourne
Breastfeeding and medications
If you are concerned about taking medication while you are breastfeeding, this fact sheet may answer some of your
questions.
Medications include:
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those prescribed by doctors
those purchased over the counter at a pharmacy e.g. pain relievers, cough and cold medicines, laxatives and
eye drops
those purchased from supermarkets
those purchased from health food stores, e.g. weight loss medicines, herbal medicines and vitamins (for
information on these products, refer to the Complementary and Alternative Medicines factsheet).
Breast milk is the best nutrient for a baby. The health benefits are so important that, should you be taking any
medications, you should only stop breastfeeding if there is substantial evidence that these medications would cause
harm to your baby.
Medications that you take can get into your breast milk and therefore into your baby. The amount of medication that
actually reaches your baby through breast milk will usually be smaller than the amount your baby is exposed to during
pregnancy, but it depends very much on the nature and properties of the medication.
It is not always possible to avoid taking medications while breastfeeding. Some women have conditions such as
asthma, diabetes, epilepsy and high blood pressure, which need ongoing treatment.
Your doctor, pharmacist, Maternal and Child Health nurse and the Royal Women’s Hospital Drug Information Centre
can assist you in making decisions regarding the safety of medicines during breastfeeding.
Aches and pain
Paracetamol (alone or in combination with codeine) may be used safely while breastfeeding in recommended doses,
to treat headache, toothache, muscular pains and to reduce fever. For more severe pain, such as migraine, products
containing paracetamol-codeine-doxylamine are considered safe if used for short periods of time.
If you need anti-inflammatory products for pain, consider ibuprofen, diclofenac or mefenamic acid.
Aspirin is an ingredient in many pain relieving products. Occasional or low doses (such as for blood thinning therapy)
are safe to take while breastfeeding. However, if taken in large doses, aspirin may pass into the breast milk and cause
adverse effects in your baby.
Should you require long-acting anti-inflammatory medication, frequent pain relievers or, if pain persists, ask your
doctor for further advice.
Allergies and hayfever
While breastfeeding, it is best to treat the individual symptoms of hayfever and allergy separately.
For eye symptoms, use eye drops (those containing antazoline or naphazoline). For nasal symptoms, use nasal
sprays (such as beclomethasone, budesonide or fluticasone).
If needed, you may use ‘sedating’ antihistamines like chlorpheniramine, cyprohetadine, dexchlorpheniramine,
doxylamine or pheniramine. If you are using them for a long period, you will need to monitor your baby for symptoms
such as drowsiness and prolonged sleep.
Less-sedating antihistamines such as cetirizine or fexofenadine are not recommended due to the lack of safety
information. If you need a less-sedating antihistamine, consider loratadine or desloratadine, as there is more
experience with their use.
Asthma
Medications used to relieve or prevent asthmatic symptoms are considered safe during breastfeeding. If you are
stabilised on inhaled corticosteroid as part of your asthma management, you are encouraged to continue therapy.
Uncontrolled asthma has the potential to pose a greater risk to you and your baby than the medications needed to
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Women's Health Information: Royal Women's Hospital, Melbourne
stabilise your condition. Your doctor or pharmacist can further advise you on your asthma management during
breastfeeding.
Common asthma relievers are salbutamol and terbutaline. Common asthma preventers are eformoterol, salmeterol,
budesonide, fluticasone, beclomethasone and steroid tablets.
Cold and flu
While breastfeeding, it is best to treat the individual symptoms of common cold or flu using single ingredient products
rather than taking multi-ingredient products like cold and flu tablets.
Aches and pain
Use appropriate pain relievers for fever, aches and pain as mentioned above.
Cough
Use a simple cough suppressant (e.g. pholcodine or dextromethorphan) for dry cough or an expectorant (e.g.
bromhexine or guaifenesin) for chesty cough.
Nasal symptoms
Try inhalations (e.g. eucalyptus and menthol oils in hot water) or a nasal spray (decongestant or saline) for nasal
congestion.
These products are considered safer than using products containing pseudoephedrine which may reduce milk
production and cause irritability and disturbed sleep in breastfed babies.
Sore throat
Lozenges or gargles containing benzydamine, cetylpyridinium or benzocaine may be used to relieve a sore throat.
Avoid products containing iodine (e.g. Betadine®). For alternative treatment, ask your doctor or pharmacist for advice.
Cold sore and mouth ulcer
Cold sore
Prevention of cold sores is always better than treatment.
o Use lip-balm with SPF-15+.
o Avoid stress.
o Eat a well balanced nutritious diet.
o Avoid too much sun/wind exposure.
o Avoid injury to the lips or skin (e.g. severe chapping).
o Avoid food or drink that can trigger the outbreak of cold sores such as alcohol, chocolates or food that may
trigger your allergic reaction e.g. peanuts.
The recommended treatment for cold sores is a cold ice compression as well as keeping the area moist using lip
balm. If the cold sore is severe, or if further treatment is needed, you may use aciclovir cream. Talk to your doctor or
pharmacist for further advice.
There is no safety information about lysine and breastfeeding, however it is unlikely to pose harm to the baby.
Mouth ulcers
Topical cream (e.g. lignocaine, triamcinolone) and protective pastes containing carmellose, gelatin and pectin are
generally considered safe to use for relieving the pain of mouth ulcers while breastfeeding. Products containing
salicylic acid or benzydamine may be an alternative treatment. Talk to your doctor or pharmacist for further advice
before using them.
Constipation / diarrhoea / heartburn
Constipation
It is always better to try adding more fibre to your diet, drinking plenty of water or consulting a dietitian before trying
laxatives.
While breastfeeding, laxatives that soften stool (e.g. docusate), add bulk to the bowel contents (e.g. psyllium or
ispaghula husk) or osmotic laxatives (e.g. lactulose) are the safest to take. If you need a stronger laxative, your doctor
or pharmacist will advise you on the most suitable preparation to use. Large doses of stimulant laxatives, such as
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Women's Health Information: Royal Women's Hospital, Melbourne
senna or bisacodyl, may pass into the breast milk and cause diarrhoea in your baby.
Use of liquid paraffin should be limited to one or two weeks as it may affect the absorption of some vitamins when
used for prolonged periods.
Diarrhoea
Most cases of acute diarrhoea are short-lived and do not require treatment with drugs. It is a good idea to use oral
rehydration solutions to replace the loss of fluid and electrolytes. If diarrhoea has not stopped within 24 to 48 hours,
talk to your doctor or pharmacist before starting any treatment.
Loperamide or a combination of diphenoxylate-atropine may be used to treat diarrhoea, when required, as long as the
diarrhoea is not related to an infection.
Heartburn
Antacids containing magnesium or calcium can be used to relieve heartburn symptoms when you are breastfeeding. If
you require a stronger preparation, speak to your doctor or pharmacist for further advice.
Contraception
Contraceptives
For breastfeeding women who require contraception, any of the following methods are considered suitable:
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The ‘minipill’, which contains low dose progestogen hormone e.g. levonorgestrel or norethisterone.
An injection of medroxyprogesterone.
An intrauterine device (IUD).
A progestogen implant.
You should avoid other combined contraceptive pills containing oestrogen-progesterone hormones as they can
decrease breast milk production.
Morning after pill
If you require the morning after pill you should discuss your options with a doctor or pharmacist.
Head lice and scabies
If you need treatment for head lice or scabies, you can use products containing permethrin or piperonyl butoxide.
These products should not be used to prevent infestation, but rather for treatment when you have confirmed head lice
or scabies.
If unsure of the diagnosis, talk to your doctor or pharmacist.
Infection (fungal and bacterial)
Bacterial infections
Bacterial infections require antibiotic treatment prescribed by your doctor. There are many suitable antibiotics if you
require treatment. Talk to your doctor or pharmacist for further advice.
Fungal infections (e.g. thrush, athletes foot)
There are many over-the-counter and prescription medications available to treat fungal infections. Topical antifungals
such as clotrimazole, ketoconazole, miconazole, nystatin and terbinafine are considered safe to use while
breastfeeding. If you require tablet forms of fluconazole, ketoconazole or terbinafine, talk to your doctor or pharmacist
for further advice.
Vaccination
Vaccination in general is considered safe when breastfeeding. There is no evidence of risk to the breastfed baby if the
mother is vaccinated with any of the live or inactivated vaccines.
Weight control
You should not use weight reducing agents during breastfeeding unless suggested by your doctor. Healthy eating or
dietary modification is the safest alternative. Your doctor or dietitian can help to develop a plan that is appropriate for
Tel: (03) 8345 3045 or 1800 442 007 (rural callers) – www.thewomens.org.au - April 11
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Women's Health Information: Royal Women's Hospital, Melbourne
you.
Where to get more information
If this brochure does not answer your questions about a particular medication, or you are still unclear about what you
should do, then seek further advice. Your doctor, local pharmacist and the Royal Women's Hospital Drug Information
Centre can assist you in making decisions regarding the safety of medications during breastfeeding.
Royal Women's Hospital
Drug Information Centre - Pharmacy Department
Hours 9am – 5pm Monday to Friday
After hours answering machine
Tel: (03) 8345 3190
Email: drug.information@thewomens.org.au
Web: http://www.thewomens.org.au/AskaPharmacist
For women with drug and alcohol issues contact:
Women’s Alcohol and Drugs Service
The service offers confidential and supportive care to promote a healthy outcome for you and your baby.
Tel: (03) 8345 3931
Email: wads@thewomens.org.au
Related fact sheets

Complementary and alternative medicines and breastfeeding
Disclaimer
The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such
information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this
information on the understanding that all persons accessing it take responsibility for assessing its relevance and
accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about
your health, you should seek advice from your health care provider or if you require urgent care you should go to the
nearest Emergency Dept.
Published Feb 2007. Last updated April 2008
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