Table 6.
Maternal Medication Usually Compatible With Breastfeeding*
| Drug | Reported Sign or Symptom in Infant or Effect on Lactation | Reference No. |
|---|---|---|
| Acetaminophen | None | 142–144 |
| Acetazolamide | None | 145 |
| Acitretin | — | 146 |
| Acyclovir† | None | 147, 148 |
| Alcohol (ethanol) | With large amounts, drowsiness, diaphoresis, deep sleep, weakness, decrease in linear growth, abnormal weight gain; maternal ingestion of 1 g/kg daily decreases milk ejection reflex | 4, 149–152 |
| Allopurinol | — | 153 |
| Amoxicillin | None | 154 |
| Antimony | — | 155 |
| Atropine | None | 156 |
| Azapropazone (apazone) | — | 157 |
| Aztreonam | None | 158 |
| B1(thiamin) | None | 159 |
| B6(pyridoxine) | None | 160–162 |
| B12 | None | 163 |
| Baclofen | None | 164 |
| Barbiturate | See Table 5 | |
| Bendroflumethiazide | Suppresses lactation | 165 |
| Bishydroxycoumarin (dicumarol) | None | 166 |
| Bromide | Rash, weakness, absence of cry with maternal intake of 5.4 g/d | 167 |
| Butorphanol | None | 168 |
| Caffeine | Irritability, poor sleeping pattern, excreted slowly; no effect with moderate intake of caffeinated beverages (2–3 cups per day) | 169–174 |
| Captopril | None | 175 |
| Carbamazepine | None | 176, 177 |
| Carbetocin | None | 178 |
| Carbimazole | Goiter | 83, 179, 180 |
| Cascara | None | 181 |
| Cefadroxil | None | 154 |
| Cefazolin | None | 182 |
| Cefotaxime | None | 183 |
| Cefoxitin | None | 183 |
| Cefprozil | — | 184 |
| Ceftazidime | None | 185 |
| Ceftriaxone | None | 186 |
| Chloral hydrate | Sleepiness | 187 |
| Chloroform | None | 188 |
| Chloroquine | None | 189–191 |
| Chlorothiazide | None | 192, 193 |
| Chlorthalidone | Excreted slowly | 194 |
| Cimetidine† | None | 195, 196 |
| Ciprofloxacin | None | 197, 198 |
| Cisapride | None | 199 |
| Cisplatin | Not found in milk | 30 |
| Clindamycin | None | 200 |
| Clogestone | None | 201 |
| Codeine | None | 144, 156, 202 |
| Colchicine | — | 203–205 |
| Contraceptive pill with estrogen/progesterone | Rare breast enlargement; decrease in milk production and protein content (not confirmed in several studies) | 206–213 |
| Cycloserine | None | 214 |
| D (vitamin) | None; follow up infant's serum calcium level if mother receives pharmacologic doses | 215–217 |
| Danthron | Increased bowel activity | 218 |
| Dapsone | None; sulfonamide detected in infant's urine | 191, 219 |
| Dexbrompheniramine maleate withd-isoephedrine | Crying, poor sleeping patterns, irritability | 220 |
| Diatrizoate | None | 221 |
| Digoxin | None | 222, 223 |
| Diltiazem | None | 224 |
| Dipyrone | None | 225 |
| Disopyramide | None | 226, 227 |
| Domperidone | None | 228 |
| Dyphylline† | None | 229 |
| Enalapril | — | 230 |
| Erythromycin† | None | 231 |
| Estradiol | Withdrawal, vaginal bleeding | 232 |
| Ethambutol | None | 214 |
| Ethanol (cf. alcohol) | — |
| Drug | Reported Sign or Symptom in Infant or Effect on Lactation | Reference No. |
|---|---|---|
| Ethosuximide | None, drug appears in infant serum | 176, 233 |
| Fentanyl | — | 234 |
| Fexofenadine | None | 235 |
| Flecainide | — | 236, 237 |
| Fleroxacin | One 400-mg dose given to nursing mothers; infants not given breast milk for 48 h | 238 |
| Fluconazole | None | 239 |
| Flufenamic acid | None | 240 |
| Fluorescein | — | 241 |
| Folic acid | None | 242 |
| Gadopentetic (Gadolinium) | None | 243 |
| Gentamicin | None | 244 |
| Gold salts | None | 245–249 |
| Halothane | None | 250 |
| Hydralazine | None | 251 |
| Hydrochlorothiazide | — | 192, 193 |
| Hydroxychloroquine† | None | 252, 253 |
| Ibuprofen | None | 254, 255 |
| Indomethacin | Seizure (1 case) | 256–258 |
| Iodides | May affect thyroid activity; see iodine | 259 |
| Iodine | Goiter | 259 |
| Iodine (povidone-iodine, eg, in a vaginal douche) | Elevated iodine levels in breast milk, odor of iodine on infant's skin | 259 |
| Iohexol | None | 97 |
| Iopanoic acid | None | 260 |
| Isoniazid | None; acetyl (hepatotoxic) metabolite secreted but no hepatotoxicity reported in infants | 214, 261 |
| Interferon-α | — | 262 |
| Ivermectin | None | 263, 264 |
| K1 (vitamin) | None | 265, 266 |
| Kanamycin | None | 214 |
| Ketoconazole | None | 267 |
| Ketorolac | — | 268 |
| Labetalol | None | 269, 270 |
| Levonorgestrel | — | 271–274 |
| Levothyroxine | None | 275 |
| Lidocaine | None | 276 |
| Loperamide | — | 277 |
| Loratadine | None | 278 |
| Magnesium sulfate | None | 279 |
| Medroxyprogesterone | None | 201, 280 |
| Mefenamic acid | None | 281 |
| Meperidine | None | 61, 282 |
| Methadone | None | 283–287 |
| Methimazole (active metabolite of carbimazole) | None | 288, 289 |
| Methohexital | None | 61 |
| Methyldopa | None | 290 |
| Methyprylon | Drowsiness | 291 |
| Metoprolol† | None | 120 |
| Metrizamide | None | 292 |
| Metrizoate | None | 97 |
| Mexiletine | None | 293, 294 |
| Minoxidil | None | 295 |
| Morphine | None; infant may have measurable blood concentration | 282, 296–298 |
| Moxalactam | None | 299 |
| Nadolol† | None | 300 |
| Nalidixic acid | Hemolysis in infant with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency | 301 |
| Naproxen | — | 302 |
| Nefopam | None | 303 |
| Nifedipine | — | 304 |
| Nitrofurantoin | Hemolysis in infant with G-6-PD deficiency | 305 |
| Norethynodrel | None | 306 |
| Norsteroids | None | 307 |
| Noscapine | None | 308 |
| Ofloxacin | None | 198 |
| Oxprenolol | None | 309, 310 |
| Phenylbutazone | None | 311 |
| Phenytoin | Methemoglobinemia (1 case) | 138, 176, 312 |
| Piroxicam | None | 313 |
| Prednisolone | None | 314, 315 |
| Prednisone | None | 316 |
| Drug | Reported Sign or Symptom in Infant or Effect on Lactation | Reference No. |
|---|---|---|
| Procainamide | None | 317 |
| Progesterone | None | 318 |
| Propoxyphene | None | 319 |
| Propranolol | None | 320–322 |
| Propylthiouracil | None | 323 |
| Pseudoephedrine† | None | 324 |
| Pyridostigmine | None | 325 |
| Pyrimethamine | None | 326 |
| Quinidine | None | 191, 327 |
| Quinine | None | 296 |
| Riboflavin | None | 159 |
| Rifampin | None | 214 |
| Scopolamine | — | 156 |
| Secobarbital | None | 328 |
| Senna | None | 329 |
| Sotalol | — | 237, 330 |
| Spironolactone | None | 331 |
| Streptomycin | None | 214 |
| Sulbactam | None | 332 |
| Sulfapyridine | Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk | 333, 334 |
| Sulfisoxazole | Caution in infant with jaundice or G-6-PD deficiency and ill, stressed, or premature infant; appears in infant's milk | 335 |
| Sumatriptan | None | 336 |
| Suprofen | None | 337 |
| Terbutaline | None | 338 |
| Terfenadine | None | 235 |
| Tetracycline | None; negligible absorption by infant | 339, 340 |
| Theophylline | Irritability | 169, 341 |
| Thiopental | None | 139, 342 |
| Thiouracil | None mentioned; drug not used in United States | 343 |
| Ticarcillin | None | 344 |
| Timolol | None | 310 |
| Tolbutamide | Possible jaundice | 345 |
| Tolmetin | None | 346 |
| Trimethoprim/sulfamethoxazole | None | 347, 348 |
| Triprolidine | None | 324 |
| Valproic acid | None | 176, 349, 350 |
| Verapamil | None | 351 |
| Warfarin | None | 352 |
| Zolpidem | None | 353 |
-
↵* Drugs listed have been reported in the literature as having the effects listed or no effect. The word “none” means that no observable change was seen in the nursing infant while the mother was ingesting the compound. Dashes indicate no mention of clinical effect on the infant. It is emphasized that many of the literature citations concern single case reports or small series of infants.
-
↵† Drug is concentrated in human milk.
