Breastmilk & Medication, What You Need to Know

In many cases, our incredibly caring surrogates are willing and able to express breast milk for your child following the birth. This is an incredible gift, as breastmilk provides antibodies that can help your child’s immune system in the first weeks of life as well as provide incredible nutrition. While breastmilk is not mandatory to a healthy infant, many intended parents accept this gift from their surrogates. However, you should note that, following birth, many surrogates will return to the use of over the counter medications. While generally safe to do, you’ll want to note that many medications can cross into the breastmilk supply, and thus, into your baby’s digestive system.

The first thing we’d like you to remember is that surrogates in our program are all mothers themselves, and have likely done research previously into what medications are safe for lactating women. Our surrogates are also incredibly careful with themselves and, as you’ve just witnessed first-hand, with your child. Please don’t underestimate their attention to detail and desire to provide your child with the best breastmilk possible. We have faith in our surrogates to talk to their doctors about medications before taking them and trust that they’d never take medication that could harm your child.

Understand that any medication that enters the bloodstream will most likely wind up in a woman’s breastmilk in some concentration. Different drugs metabolize differently within the system, leading to trace amounts of some drugs and a higher concertation of others. We advise our surrogates to let you know if she has taken any new medication. This is not because of potential harm to your child, so much as it is a considerate heads up to allow you to keep an eye on your child for any potential impacts.

Different babies will react differently to medications, just as adults can. This means that, while a medication is generally safe, you’ll want to be aware that it may be in your surrogate’s breastmilk in order to watch for any unique reactions it may have on your new baby. In general, premature babies, babies younger than six months of age, or those with weakened kidneys or immune systems should receive particular consideration to medications taken by a nursing woman.

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:

  • Tylenol
  • Motrin
  • Advil
  • Aleve
  • Penicillin
  • Claritin
  • Allegra
  • Alavert
  • Sudafed
  • Zyrtec
  • Colace
  • Paxil
  • Zoloft

When it comes to oral birth control pills, some are considered safe, while others are generally avoided. Typically, Progestin-only pills are the best bet.

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. 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 may not be able to obtain breastmilk from their surrogate. Some women do not desire to lactate, and that’s not to be seen as an insult to your relationship. Lactation is a time-intensive and often painful process that some women would just prefer to avoid. Despite that, we understand that some intended parents will desire breastmilk anyway.

In these instances, it is not uncommon for intended parents to reach out to a milk bank. Milk Banks will have unique lists of medications that donors are or are not allowed to consume during their donation periods. If you choose to look into a milk bank, you’ll want to talk with them about these allowed medications as well.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: An Essential Guide to Assisted Reproduction (Red Wheel Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.