Drugs to avoid in breastfeeding mnemonic

Contraindications to Breastfeeding or Feeding Expressed Breast Milk to Infants

While human milk provides the most complete form of nutrition for infants, including premature and sick newborns, there are rare exceptions when human milk or breastfeeding is not recommended. Additional information about these conditions is available by clicking the links provided.

Contraindications to Breastfeeding or Feeding Expressed Breast Milk to Infants

Physicians should make case-by-case assessments to determine whether a woman’s environmental exposure, her own medical condition, or the medical condition of the infant warrants her to interrupt, stop, or never start breastfeeding.

Mothers may be able to resume breastfeeding after consulting with a physician to determine when their breast milk is safe for their infant. These mothers should be provided with lactation support to learn how to maintain milk production and feed their infants with pasteurized donor human milk or formula while temporarily not breastfeeding.

  • Mother is infected with untreated brucellosis1
  • Mother is taking certain medications1,2
  • The mother is undergoing diagnostic imaging pdf icon[PDF-778KB]external icon with radiopharmaceuticals2
  • Mother has an active herpes simplex virus [HSV] infection with lesions present on the breast3 [Note: Mothers can breastfeed directly from the unaffected breast if lesions on the affected breast are covered completely to avoid transmission]

Mothers may be able to resume breastfeeding after consulting with a physician to determine when their breast milk is safe for their infant. These mothers should be provided with lactation support to learn how to maintain milk production and feed their infants with pasteurized donor human milk or formula while temporarily not breastfeeding.

Airborne and contact precautions may require temporary separation of the mother and infant, during which time expressed breast milk should be given to the infant by another care provider. Mothers should be able to resume breastfeeding after consulting with a physician to determine when there is no longer a risk of spreading infection. These mothers should be provided with lactation support to learn how to maintain milk production while not breastfeeding and/or while expressing their milk.

  • Mother has untreated, active tuberculosis1
    [Note: The mother may resume breastfeeding once she has been treated appropriately for 2 weeks and is documented to be no longer contagious]
  • Mother has active varicella pdf icon[PDF-805KB]external icon [chicken pox] infection that developed within the 5 days prior to delivery to the 2 days following delivery1

Airborne and contact precautions may require temporary separation of the mother and infant, during which time expressed breast milk should be given to the infant by another care provider. Mothers should be able to resume breastfeeding after consulting with a physician to determine when there is no longer a risk of spreading infection. These mothers should be provided with lactation support to learn how to maintain milk production while not breastfeeding and/or while expressing their milk.

Few medications are contraindicated while breastfeeding. Although many medications do pass into breast milk, most have no known adverse effect on milk supply or on infant well-being. However, healthcare providers should always weigh the risks and benefits when prescribing medications to breastfeeding mothers.

Learn more about safe prescription medication use while breastfeeding.

Review the most up-to-date information available on medications and lactation on LactMed®external icon.

  • Journal List
  • Can Fam Physician
  • v.46; 2000 Sep
  • PMC2145042

Can Fam Physician. 2000 Sep; 46: 1753–1757.

Abstract

QUESTION: Many breastfeeding mothers are concerned about taking medications that might affect their babies. Are there any guidelines on which drugs are safe? ANSWER: Only a few drugs pose a clinically significant risk to breastfed babies. In general, antineoplastics, drugs of abuse, some anticonvulsants, ergot alkaloids, and radiopharmaceuticals should not be taken, and levels of amiodarone, cyclosporine, and lithium should be monitored.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy [PDF file] of the complete article [31K], or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  • Tunnessen WW, Jr, Hertz CG. Toxic effects of lithium in newborn infants: a commentary. J Pediatr. 1972 Oct;81[4]:804–807. [PubMed] [Google Scholar]
  • Dahlström A, Lundell B, Curvall M, Thapper L. Nicotine and cotinine concentrations in the nursing mother and her infant. Acta Paediatr Scand. 1990 Feb;79[2]:142–147. [PubMed] [Google Scholar]
  • Kelsey JJ. Hormonal contraception and lactation. J Hum Lact. 1996 Dec;12[4]:315–318. [PubMed] [Google Scholar]
  • Rubow S, Klopper J, Wasserman H, Baard B, van Niekerk M. The excretion of radiopharmaceuticals in human breast milk: additional data and dosimetry. Eur J Nucl Med. 1994 Feb;21[2]:144–153. [PubMed] [Google Scholar]
  • Romney BM, Nickoloff EL, Esser PD, Alderson PO. Radionuclide administration to nursing mothers: mathematically derived guidelines. Radiology. 1986 Aug;160[2]:549–554. [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

Which medication should be avoided while breastfeeding?

Drugs contraindicated during breastfeeding include anticancer drugs, lithium, oral retinoids, iodine, amiodarone and gold salts. An understanding of the principles underlying the transfer into breast milk is important, as is an awareness of the potential adverse effects on the infant.

What are the 5 true contraindications to breastfeeding?

Contraindications.
Congenital Diaphragmatic Hernia..
Oesophageal atresia/ tracheo-oesophageal fistula..
Intestinal obstruction..
Imperforate anus..
Gastroschisi/omphalocele..
Most Important - Galactosemia..

Which drug is contraindicated in pregnancy and lactation?

Warfarin [Coumadin] Warfarin [Coumadin] is a blood thinner that's used to treat blood clots as well as prevent them. It can cause birth defects. It should be avoided during pregnancy unless the risk of a blood clot is more dangerous than the risk of harm to the baby.

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