Most drugs are safe for mothers to take while breastfeeding their babies, according to a group of U.S. pediatricians, but women should still be cautious about breastfeeding if they use narcotic painkillers or anti-depressants.
The report from the American Academy of Pediatrics seeks to change many drug labels that have blanket statements warning women against taking any medication while pregnant or nursing.
“The benefits of breastfeeding outweigh the risk of exposure to most therapeutic agents via human milk,” said the report published in the September issue of Pediatrics.
“Many mothers are inappropriately advised to discontinue breastfeeding or avoid taking essential medications because of fears of adverse effects on their infants. This cautious approach may be unnecessary in many cases, because only a small proportion of medications are contraindicated in breastfeeding mothers or associated with adverse effects on their infants.”
The report suggests that doctors avoid prescribing opioid painkillers, such as codeine, hydrocodone and oxycodone, to nursing mothers because opioids are known to cause health problems in breastfed infants. Medications such as ibuprofen, acetaminophen, and naproxen may be safer choices for pain relief, according to the report.
Caution is also warranted for drugs that become concentrated in human milk, have a long half-life, have a known toxicity to mother or child, or expose the infant to high doses or detectable serum concentrations. Premature infants are more vulnerable to drugs in breast milk due to immature organs and other health issues.
The report refers women and their doctors to LactMed, a database of information on drugs in breast milk maintained by the U.S. National Library of Medicine. While the database covers over 450 medications, which is only a fraction of the 3,000 drugs that are available. Most medications have never been studied in breastfeeding women.
The report recommends counseling for women who want to breastfeed while taking antidepressants or antipsychotics, because of the unknown long-term impact on the child.