Canterbury DHB

Context

Prescribing in Breastfeeding

All medicines transfer into breast milk.
 
The benefits of breastfeeding outweigh the risk of exposure to most medicines via breast milk.

In This Section

General Advice

General Advice

 Medicines considered "safe" when breastfeeding full-term healthy babies

The following is a guide only and the list is not exhaustive.

Class

Examples of Individual Medicines

Analgesics

opioid analgesics* (short courses < 2 days): morphine, oxycodone, codeine, paracetamol, diclofenac, ibuprofen

Anticoagulants

enoxaparin, heparin, warfarin (monitor infant INR)

Antiepileptic drugs*

carbamazepine, phenytoin, valproate sodium

Antidepressants*

SSRIs: citalopram, escitalopram, paroxetine, sertraline

SNRIs: venlafaxine

tricyclics: amitriptyline, nortriptyline

Antidiabetic

insulin, metformin

Antihistamines

cetirizine, loratadine

Antihypertensives

ACE inhibitors: enalapril, quinapril

beta blockers: labetalol, metoprolol, propanolol

calcium channel blockers: diltiazem, nifedipine

methyldopa

Antimicrobials

betalactams: amoxicillin, flucloxacillin

cephalosporins: cefalexin, ceftriaxone, cefazolin, cefuroxime, cefotaxime, cefepime, ceftazidime

macrolides: azithromycin, clarithromycin, erythromycin, roxithromycin

metronidazole (shorter courses – e.g. 400 to 600 mg BD for 7 to 10 days; avoid higher doses e.g. 2000 mg)

nitrofurantoin

trimethoprim, trimethoprim/sulfamethoxazole

aciclovir, valaciclovir

Antipsychotics*

haloperidol, olanzapine, quetiapine, risperidone

Hypnotics*

short courses (< 2 days) of midazolam, temazepam, zopiclone

Cardiac glycoside

digoxin

Contraceptives

progestogen-only, combined oral contraceptives after 6 weeks post-partum

Corticosteroids (short courses)

prednisone (< 20 mg/day)

Gastrointestinal drugs

domperidone

proton pump inhibitors: omeprazole, pantoprazole

mesalazine

ranitidine

* For all, monitor infant for adverse effects (e.g. sedation, jitteriness, lethargy, poor feeding).

Medicines considered "unsafe" during breastfeeding

Information about this Canterbury DHB document (93270):

Document Owner:

Not assigned (see Who's Who)

Last Updated:

May 2019 (Prescribing in Breastfeeding)

Next Review Due:

May 2022

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.

Topic Code: 93270