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Most prescription and over the counter drugs, including contraceptives, are considered safe while breastfeeding. A few medications are not safe while breastfeeding. The decision is made by assessing the risk/benefit ratio of a small amount of a drug compared to the tremendous benefit of breastfeeding to the infant.
In general, only small amounts of medications that are acidic, water soluble, highly protein bound, and with low oral bioavailability pass into milk. Drugs of large molecular size do not cross the membrane into the milk. If a mother can take a medication while pregnant, or if the medication is given to infants, it is usually compatible with breastfeeding.
Resources for information on maternal medications during breastfeeding:
The American Academy of Pediatrics Policy Statement on
"The Transfer of Drugs and Other Chemicals into Human Milk":
This document contains a comprehensive list of maternal medications and their affect on the breastfeeding infant.
The Breastfeeding Pharmacology website of Dr. Thomas Hale: http://neonatal.ttuhsc.edu/lact/.
Physicians may call the Breastfeeding and Human Lactation Study Center at the University of Rochester for free information regarding medications during breastfeeding: http://www.cdc.gov/breastfeeding/compend-bhlsc.htm
Berlin CM. Update: Transfer Of Drugs and Chemicals into Human Milk, Breastfeeding Abstracts, August 2001. (21), 1: 3-4: http://www.lalecheleague.org/ba/Aug01.html
Reference: Lawrence RA. 1997. A Review of the Medical Benefits and Contraindications to Breastfeeding in the United States (Maternal and Child Health Technical Information Bulletin). Arlington, VA: National Center for Education in Maternal and Child Health.
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