Breastfeeding Report Card: Which Medications Are Safe?
The struggle for mothers about what medications to take continues because little research has been done on which drugs are safe while breastfeeding, according to the New York Times.
A doctor did offer some encouragement amid the questions, however. Dr. Thomas Hale, professor of pediatrics at Texas Tech University Health Sciences Center in Lubbock, said it was likely “the vast majority of drugs” available to the public are safe to take while breastfeeding if the dose is moderate.
For most medications, according to available research, less than 3 percent of a mother’s dose of a drug can make it into her breast milk.
“Nature really figured out how to make the breast milk compartment safe — isolated somewhat from the rest of the body — with the primary intent of safeguarding the baby,” Hale said.
Breastfeeding and meds: What's safe?
That means that despite a rise each year in the number of women who breastfeed, “shockingly little solid evidence” exists on how many of those drugs may affect breast milk and nursing infants, according to Dr. Catherine Spong, chief of the division of maternal-fetal medicine at the University of Texas Southwestern Medical Center in Dallas.
Pregnant and nursing women are excluded from most clinical drug studies over fears of possible harms, Spong said. That has led to the paradox of the people who most need answers about taking medication while breastfeeding being left out of the studies that could supply those answers.
Among infants born in 2015 in the United States, four out of five, over 83 percent, started to breastfeed, according to the U.S. Centers for Disease Control and Prevention.
According to The Times story, half of mothers who breastfeed — an estimated 1.5 million women a year — will take medication.
The Mayo Clinic said most medications are safe to take while breastfeeding. Most medications present in blood will transfer into breast milk at low levels and pose no real risk to most infants, but every medication should be considered separately.
One result is some women forgoing breastfeeding when taking medications or deciding not to take needed meds at all, said Dr. Christina Chambers, professor of pediatrics at the University of California, San Diego.
Some drugs require more caution
Sprong led a federal study on research specific to pregnant and lactating women published in September 2018. Over six million women are pregnant in the U.S. each year, and of these, over 90 percent take at least one medication during pregnancy and lactation, the study found.
Spong and others said it’s neither difficult nor expensive to study women who are already taking medication, but that kind of research hasn’t been a priority.
In most cases, medications that are already proven safe for babies — such as acetaminophen (Tylenol), ibuprofen (Advil) or certain antibiotics like amoxicillin — are safe to take while nursing.
Among drugs that might cause serious side effects at their recommended dosages are those used for chemotherapy or certain radioactive drugs.
Some sedatives should be used with caution since they can cause excessive drowsiness and breathing problems in infants. These include the anti-anxiety drugs alprazolam (Xanax) or diazepam (Valium), the anti-nausea drug promethazine (Phenergan) and prescription sleep aids.
As for birth control, the American Academy of Pediatrics said all hormonal contraceptives are safe for the baby.
Spong advised against taking herbal products marketed to improve milk supply, such as fenugreek and milk thistle, because of a lack of evidence that they work.
Contact Tyrone Birth Injury Lawyers today for help with cases involving taking medication while breastfeeding and for help with birth-injury cases.