It is so hard to know what to take and what not to take when you are breastfeeding. Of course there are common over the counter drugs that are well known to be safe, but what if you have a medical condition, anxiety or depression? Can you rely on your doctor to know which drugs pass through to human milk and which ones are safe?
The best advise we can offer is to ask your doctor what medications he would prefer to prescribe and if there is an alternative as well. Then before you have your RX filled, research the medications of the following websites or apps:
https://www.ncbi.nlm.nih.gov/books/NBK501922/
The National Center for Biotechnology Information (NCBI) is part of the United States National Library of Medicine (NLM), a branch of the National Institutes of Health. The NCBI is located in Bethesda, Maryland and was founded in 1988.
Thomas Hale, PHD wrote Medications and Mother's Milk and updates are published frequently, but the best way to keep up to date on the information in this highly valuable resource is through an app so that you receive the most current information on medications. You can find Hale's app for Apple and Android.
https://apps.apple.com/us/app/medications-mothers-milk/id1400067173
https://play.google.com/store/apps/details?id=com.hltcorp.medsmilk&hl=en_US&gl=US
The Physicians Desk Reference if often used by doctors and it contains information on medications and nursing derived from package inserts from the pharmaceutical manufacturers. Almost across the board, they indicate that each medication should not be taken while pregnant or breastfeeding. The warning statements they use are designed to protect themselves from lawsuits. The information in the PDR is based on the manufacturer’s studies on the product, but not other studies that have been done. In general the manufacturers have done no studies on lactating women, and thus say that there is no information (even if studies have been done by others). Many doctors also have access to the USPDI (US Pharmacopeia Drug Information), which tends to have more accurate information about studies done on the drug and available information about transfer into milk than the PDR (Physican's Desk Reference). If your physician does not use LactMed or Thomas Hale's resources, make sure they are not just relying on the PDR.
LactMed and Thomas Hale are the foremost authorities on medication and mother's milk and heavily relied on by board certified lactation consultants and the lactation community at large.
If you have taken a medication that has decreased your milk supply, here are two resources that may help with galactagogues to increase your supply and protocols to replace supplements with breastmilk once your supply is on the rise.
https://www.lactationconnection.com/Lactation-Supplements-s/1854.htm
https://lactconnect.blogspot.com/2019/02/getting-back-to-breastfeeding-pumping.html
Best wishes for the best health for you, your baby and your milk supply!
Tanya
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