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Medications and Mother's Milk
Many medications are safe for breastfeeding and alternatives are usually available for those that are not so it is unusual to have to stop breastfeeding due to a short term drug regimen. Thomas Hale, PHD is the foremost authority on medications and mothers milk and his book is vital for nursing mothers and health care professionals alike. This information is intended for reference only and is in no way to take the place of the individualized care of a qualified physician. Below is a list of some common medications which are approved by the AAP for use in breastfeeding mothers:

ACNE - Clindamycin (topical), Erythromycin (oral)

ALLERGIC RHINITIS - Triprolidine

ANESTHETIC - Bupivacaine, Fentanyl, Halothane, Ketorolac, Lidocaine, Lorazepam, Metoclopramide, Morphine, Thiopental Sodium

ANGINA PECTORIS - Metoprolol, Nifedipine, Propranolol, Verapamil

ANTICOAGULATION THERAPY - Warfarin

ANXIETY DISORDERS - Clomipramine, Propranolol

ASTHMA - Terbutaline, Theophylline, Methylprednisolone

BIPOLAR DISORDER - Carbamazepine, Valproic Acid, Verapamil

CARDIAC ARRHYTHMIAS - Atenolol, Digoxin, Disopyramide, Lidocaine, Metoprolol, Mexiletine HCL, Phenytoin, Procainamide, Propranolol, Quinidine, Sotalol, Verapamil, Warfarin

CONGESTIVE HEART FAILURE - Captopril, Digoxin, Enalapril Maleate, Hydralazine, Metoprolol, Nifedipine, Verapamil

CONJUNCTIVITIS - Ceftriaxone, Erythromiacin, Tetracycline (short term)

CONTRACEPTION - Levonorgestrel

COUGH - Cisapride, Codeine

DEPRESSION - Clomipramine

DIABETES - Tolbutamide

FEVER - Acetaminophen, Ibuprofen

GASTROESOPHAGEAL REFLUX - Cisapride

GLAUCOMA - Acetazolamide, Timolol

HEADACHE/PAIN, GENERAL - Acetaminophen, Codeine, Ibuprofen, Naproxen

HYPERTENSION - Atenolol, Captopril, Enalapril Maleate, Hydralazine, Labetalol, Metaprolol, Nifedipine, Propranolol, Sotalol, Verapamil

HYPERTHYROIDISM - Methimazole, Proprnolol, Propylthiouracil,

INFLAMMATORY BOWEL DISEASE - Prednisone

INSUFFICIENT MILK SUPPLY - Metoclopramide (Reglan: short term only - use for less than 2 months), Domperidone

LOW BACK PAIN - Acetaminophen, Codeine, Ibuprofen, Naproxen

MASTITIS - Cefazolin, Cephalexin, Clindamycin

METABOLIC BONE DISEASE - Fluoride, Vitamin D

MIGRAINE - Butorphanol, Ketorolac, Metoprolol, Nifedipine, Propranolol, Valproic Acid, Verapamil

MUSCLE SPASTICITY - Quinine

NIPPLE VASOSPASM - Captopril, Methyldopa, Nifedipine, Terbutaline

PELVIC INFLAMMATORY DISEASE - Ceftriaxone, Cefoxitin

PEPTIC ULCER DISEASE - Amoxicillin, Tetracycline (short term)

RADIOPAQUE/RADIOCONTRAST AGENTS - Trade names: Conray, Chlolebrine, Telepaque, Oragrafin, Bilivist, Hypaque, Gastrografin, Renovue-Dip, Angiovist, Optiray

RADIOACTIVE PROCEDURES - The following are approved with temporary cessation of breastfeeding: Technetium-99M Pertechnetate (pump and dump for 24 hours), Iodine 123 (pump and dump for 24 hours), Thallium 201 (pump and dump for 2 weeks)

RAYNAUD'S PHENOMENON - Catopril, Methyldopa, Nifedipine, Terbutaline

RHEUMATOID ARTHRITIS - Hydroxychloroquine, Ibuprofen, Ketorolac, Piroxicam, Prednisone

ROSACEA - Clindamycin lotion/gel, Erythromycin, Tetracycline (short term)

SEIZURE DISORDERS - Carbamazepine, Ethosuximide, Phenitoin, Valproic Acid

URINARY TRACT INFECTION - Trimethoprim

VENOUS THROMBOEMBOLISM - Warfarin,

Infectious Disease Medications Approved for use In Lactation Women

Acute Sinusitis - Amoxicillin+ Clavulanate, Cefprozil, Co-Trimoxazole

Chlamydia - Erythromycin

Gonorrhea - Ceftriaxone

Herpes Simplex - Acyclovir

Lyme Disease - Amoxicilin, Ceftriaxone, Penicillin G

Malaria - Chloroquine, Hydroxychloroquine, Quinidine, Quinine

Salmonellosis - Cefotaxime, Ceftriaxone, Co-Trimoxazole

Tuberculosis - Cycloserine, Ethambutol, Isoniazid, Rifampin, Streptomycin


Medications to Avoid During Lactation

Amiodarone

Antineoplastic Agents

Chloramphenicol

Ergotamine

Gold Salts

Lithium

Phenindione

Radiopharmaceuticals

Retinoids

Tetracyclines (chronic use over three weeks may cause infant bone changes)

Pseudoephedrine (preliminary unpublished studies indicate inhibition of prolactin and milk production)

If copying this information for publication, please include references at the bottom and a link to our web site: http://www.lactationconnection.com

References: Clinical Therapy in Breastfeeding Patients, Thomas W Hale, PHD; Medications and Mother's Milk 10th Edition, Thomas W Hale, PHD