Meds & Lactation

Do your clients ever call you wondering if a particular medication is compatible with breastfeeding? Many times nursing mothers are told to “pump and dump” or wean by their physicians when in fact, it’s unnecessary. Other times, it’s assumed if a medication is over-the-counter or an herb, it’s completely safe. This is not always the case. Check below for the most widely used evidence-based resources in order to evaluate drug risk during lactation. This list is by no means exhaustive, so if you feel another database or resource belongs here, let me know.

Questions for lactation professionals and nursing mothers to consider when evaluating risk levels of drugs, herbs, chemicals, etc. during lactation:

1) Will the drug, etc. affect my baby?
2) Will the drug, etc. affect lactation?
3) What are the risks of weaning?
4) What are the options?

Electronic Databases

e-lactancia – Compiled by pediatricians affiliated with APILAM. Uses risk levels 0 (no risk) -3 (very high risk). Covers “medical prescriptions, phytotherapy (plants), homeopathy and other alternative products, cosmetic and medical procedures, contaminants, maternal and infant diseases and more.” For common FAQs concerning lactation and medications, see here. Very easy to use and understand. A great resource to share with families so they can look up their own medications.

Infant Risk – Researched and compiled by Dr. Thomas Hale, PhD and author of the famous and widely used medical lactation risk and reference guide (updated every 2 years, with the most recent edition being published in 2014) Medications and MilkUses lactation risk categories 1 (safest) – 5 (contraindicated). Covers prescription medications, chemicals, herbals, vitamins and radioisotopes/radiocontrast agents. Affiliated with the Infant Risk Center at Texas Tech University Health Sciences Center. If you have a question regarding a particular drug, you can call a free helpline at (806) 352 – 2519. A subscription to the Medications & Mother’s Milk electronic database can be purchased here. Available at varied prices for individuals, groups and institutions. A Mobile app is available for healthcare professionals for about $10 and there’s a simplified version for parents available here as well which retails for $1.99.

LactMed – Sponsored by the National Institute for Health (NIH)’s US National Library of Medicine TOXNET Toxicology Data Network. Peer reviewed and full resources provided. Users can look up lactation risk of both drugs and chemicals. This site is highly medicalized and may be too versed in “medical speak” for the average consumer to fully understand. LactMed also offers a mobile free app. 

MotherRisk – Sponsored by The Hospital for Sick Children in Toronto. MotherRisk Hotline: 1-877-439-2744.

Additional Resources

Wondering about breastfeeding and alcohol, herbals, epidurals, antidepressants, social drugs or cigarettes? Check out this comprehensive and wonderfully organized list compiled by Cindy, IBCLC, RN and creator of breastfeedingonline.com. An accessible and handy resource to share with breastfeeding families.

For common FAQs, lists of lactation risk databases in English and other languages, resources and and more references. Check out “How do I determine if a medication is safe for a breastfeeding mother?” written by Kelly Bonyata, BS, IBCLC of kellymom.com. Another great resource to share with breastfeeding families.

La Leche League (LLL) has also published some articles and FAQ fact sheets on medications and breastfeeding. Great resources to share with nursing mothers and families:

 

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