While any medication that enters your bloodstream will most likely wind up in your breastmilk, different drugs metabolize differently within your system. This leads to differing levels of every drug in breastmilk. While some drugs may leave only trace amounts in your milk supply, others can transfer dangerous drug levels to your milk that, if consumed, could be harmful to a baby. As a general rule of thumb, you should let every doctor you see during your breastmilk expression period know that you are nursing, and ask for medications that are safe for nursing mothers.
For the most part, general over the counter medications are a safe bet for women extracting breastmilk. The list of approved, safe, everyday medications that may be taken while expressing breastmilk include:
Some oral birth control pills are considered safe while others are generally avoided. Typically, Progestin-only pills are the best bet. You’ll want to talk with your OB about your family planning method and which contraceptive is best for you while you’re actively expressing breastmilk.
In addition, different babies will react differently to medications, just as adults can. This means that you should let your intended parents know if you’re on medication prior to sending that batch of milk. Of course, you should tell them that you checked with your doctor and that the medications are generally safe for nursing mothers, but it’s a kindness to let them know that your milk may be different during the time that you’re on medication, and the baby may react differently to it. In general, premature babies, babies younger than six months of age, or those with weakened kidneys or immune systems should be given particular consideration to medications taken by a nursing woman.
Doctors generally advise against taking unnecessary medications during the nursing period. These can include herbal remedies and high powered vitamins. It’s also advisable to take medication immediately after a pumping or nursing session in order to give the medication time to dilute prior to the next feeding session. As a general rule of thumb, when in doubt about any medication’s impact on breastmilk, you should ask your OB for guidance. A good online guide to general medication guidelines for nursing women can be found at https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
Occasionally, intended parents will not request breastmilk from their surrogate. In these instances, it is not uncommon for a surrogate to donate it to a milk bank. If this is the route that your journey takes, understand that every milk bank will have different regulations on medications that are deemed acceptable for use during your donation period. Impermissible medication lists will differ from milk bank to milk bank, and often include even over the counter medications that are generally regarded as safe for breastfeeding mothers. You should check with your milk bank coordinator before taking any medication to ensure that your milk will not become unacceptable due to medications.