by Ann Marie Dwyer

Created on: July 21, 2008   Last Updated: September 16, 2011

More than forty percent of women in the United States of childbearing age (18-44) take at least one prescription per day. Even though prescription drugs help mothers lead healthier lives, they are detrimental to babies who do not share mother's illnesses.

Prescription drugs enter mother's bloodstream and become part of breast milk. During breastfeeding, prescription drugs should be avoided except where medically necessary. In those instances, consulting the prescribing obstetrician and the pharmacist is mandatory. Herbal supplements and over-the-counter medicines can have the same detrimental effects as prescription medicines.

1. Stay on prescribed medicines

Some medicines can not be stopped without risking harm to the mother. These include medicines that treat:

Epilepsy
High blood pressure
Seizures
Depression
Asthma

These medicines are needed during both pregnancy and breastfeeding, since the disease's effect is worse for the child than the medicine. Consult the obstetrician to choose the medicines that will cause no or the least harm to the infant.

2. Which medicine is safest?
~The safest drugs are those that are administered topically (through the skin). These will not usually transfer to breast milk.

~Medicine that is safe for the nursing baby is safe for the mother.

~Just because medicine was approved during pregnancy does not mean that use during breastfeeding is safe.

3. How are medicines chosen for breastfeeding mothers?
~Use reliable information from the obstetrician and the sources listed at the end of this article.

~Choose medicines that are well-studied in babies. These will have the most reliable and consistent information.

~Use medicines that are poorly absorbed orally. Stomach contents are the building blocks of breast milk.

~Choose medicines with a short half-life. These prescription drug will not build up and stay in the mother's system for a long period. This reduces the amount and chance that the drug will be passed to the nursing infant.

~High protein-binding ability will allow the medicine to transfer more readily to the mother.

~Low lipid solubility will keep the drug from binding to the major ingredients of breast milk.

4. When should medicine be taken?
~Prescriptions that are taken only once per day should be taken just before the baby's longest sleep interval. By breastfeeding the baby and emptying the breasts, the milk produced will contain less medicine and will be diluted by the most "clean" breast milk.

~Multiple dose medicines should

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