Questions about Medications
and Mother's Milk
What medications can
I safely take while I'm providing breast milk for my baby?
We like to answer this question
individually for each mother and baby. That's why we don't provide a list of
"safe" or "unsafe" medications. Instead, we want you to
ask us, preferably before you begin taking something new. We look at the possible
effects of the medication on your baby and on your ability to produce milk.
How do I find out if
a specific medication is safe?
Our NICU team has lots of
experience with medications and milk for babies. Your baby's nurse, nurse practitioner,
doctor and pharmacist all know your baby very well, and can answer this question
for you, or find someone who can.
Why does the NICU team
sometimes give different advice than my doctor or my pharmacist?
The NICU team tries to find
all information, from many different sources, that might help us decide on the
best answer for you and your baby. Breastfeeding and medicine safety is not
a topic that most doctors deal with every day. Many drugstore professionals
use only one or two sources of information and don't have access to some of
the specialized publications that help us make recommendations that keep your
breast milk flowing for the baby.
What about taking vitamins?
We think mothers should
continue to take their prenatal vitamins. Iron, vitamin D and calcium in particular
are important to mothers of premature babies. Additional vitamin supplements
aren't really needed. Vitamins A, D, E and K are stored by the body, and taking
high doses of these vitamins is not a good idea. Ask before you start a vitamin
other than your prenatal vitamin.
What about herbal supplements?
Many people think herbal
supplements are natural and safe, but just because something is natural doesn't
mean it's safe. Please ask us before beginning any nutritional supplement. We
especially worry about two specific types of supplements:
- Weight-loss supplements
(such as Metabolife and Xenadrin) should not be used during breastfeeding.
Stimulants in these supplements are dangerous.
- We do not recommend herbs
such as fenugreek or blessed thistle for stimulating lactation. A complication
called necrotizing enterocolitis (NEC) has occurred in babies whose mothers
took these supplements.
Are there any medications
that help milk supply?
Milk supply problems sometimes
respond to a medication called metoclopramide or Reglan. This medication, added
to treatments such as more rest, frequent pumping, adequate fluids and good
nutrition, can be very helpful to mothers. If you are worried about milk supply
problems, talk to the Lactation Consultant first. Medications don't work very
well unless all of the other treatments for low milk supply are in place. Reglan
can have side effects, such as possible sleepiness, diarrhea and stomach cramping.
You would take the medicine for about a week. The NICU team can contact your
doctor to discuss whether Reglan would be right for you, and then your doctor
can prescribe the medication for you.
Do any medications hurt
my milk supply?
Some blood pressure medicines
and allergy medicines can affect the "let down" reflex. Some forms
of birth control also can decrease milk supply. Ask us if you have any questions
about the effects of a medication on milk supply.
Additional questions? Please
contact:
Kelly Burch, PharmD
NICU Pharmacist
314-251-6933, ext. 29133
