Part II - Is It Safe for My Baby While I'm Breastfeeding?
In this section:
Tell health care providers what medications and other substances you are taking.
Ask about different ways to take medication while breastfeeding.
Get help for substance use.
Share information with all your health care providers.
What about cancer treatment?
This section of the booklet will give you the information you need to begin understanding what is safe for your baby while
breastfeeding.
While the information in this booklet is a good starting point, it should not replace the advice women can get from their
health care provider. In fact, women may want to use this booklet to prepare themselves for more in-depth talks with their
doctor, midwife or pharmacist.
Your health care professional (e.g., doctor, nurse, midwife, pharmacist, certified lactation consultant) and the Motherisk
Information Line (416-813-6780) are the best sources of advice and information about the safety of medications, alcohol and
other substances while breastfeeding.
Tell health care providers what medications and other substances you are taking.
If you are breastfeeding, it’s important to tell all your health care providers about any substances you may have swallowed,
inhaled or used on your skin. This is because chemicals can enter the body through the skin, gums, vagina and lungs, as well
as through the stomach.
Tell health care providers about use of:
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prescription drugs, inhalers, creams
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over-the-counter drugs (e.g., cough and cold medicine, vitamins, aspirin)
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herbal remedies
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alcohol and other drugs
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cigarettes
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inhalants (glue sniffing) and solvents
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caffeine (e.g., coffee, tea, cola, cocoa, chocolate)
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cosmetics.
This information should be shared with everyone who is prescribing, supplying and giving medications; in other words, doctors,
midwives, nurses, lactation consultants, pharmacists, dentists and any other professionals involved in your care.
Some women worry that their drug use will be reported. If your health care provider has concerns that there may be physical
or emotional harm to your child because of your drug use while caring for your child (including breastfeeding), he or she
has a legal responsibility to report this to children’s protection agencies, such as the Children’s Aid Society (CAS). If
you are concerned about your health care provider’s legal or ethical responsibility, discuss this issue with him or her. Your
health care provider can also connect you with services to help you. Ask if the medication or substances you are taking can
affect your breastfeeding baby.
There are only a few prescribed and over-the-counter medications that a breastfeeding mother can NOT take. A doctor, pharmacist
or lactation consultant can help you decide whether or not to take a certain drug while breastfeeding, or how to manage breastfeeding
while taking that drug. In some cases, you may decide not to breastfeed. It is best to talk with someone who has the most
current information. It is always safest not to take any illicit drugs, alcohol, tobacco or caffeine while breastfeeding.
Ask about different ways to take medication while breastfeeding.
It is important for mothers of infants to be healthy; stopping prescribed medication (e.g., antidepressants to treat post-partum
depression and anxiety) is usually not the answer. It is always important to tell your health care professional whether or
not you are breastfeeding or planning to breastfeed. Some types of medications may be safer than others during breastfeeding
and can be used instead of your regular medication. For example, some medications do not stay in your system as long as others,
which would allow them to leave your body before feedings.
Other options for reducing any possible negative effects of a drug would be to take the medication just after breastfeeding,
as the level in the breast milk would be relatively low at that time. You could also use a breast pump just before taking
your dose of the medication — when the amount of the drug in your system is at its lowest.
If you need to take medication that is unsafe for the baby, but the treatment lasts only for a limited period, you may be
able to start breastfeeding again when the prescription is finished. You can do this by continuing to pump breast milk during
your treatment period to keep your milk supply up. You would need to throw away the milk pumped during this period. For example,
if — for seven days — you had to take a drug that would be unsafe for your baby, you might decide that that period of time
is manageable for you to pump breast milk, without giving it to the baby. It’s a personal choice. Only in rare cases is breastfeeding
not recommended.
Get help for substance use.
It’s safest to stop use of alcohol, tobacco and other drugs while breastfeeding. Many people are trained to help you deal
with a substance use problem. A family doctor, spiritual leader, nurse, social worker, counsellor and others working in social
services and public health are great people to contact initially — either to offer help directly or to give you details about
the services available in your community.
Many find it difficult to stop using alcohol and other drugs. If you need information about treatment resources, contact:
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your local hospital, helpline or crisis centre. (Check the Blue Pages of your phone book.)
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in Ontario, the Drug and Alcohol Registry of Treatment (DART) at 1-800-565-8603; outside Ontario, call (519) 439-0174. Their
Web site is
www.dart.on.ca.
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in Toronto, Metro Addiction Assessment Referral Service (MAARS) at (416) 599-1448.
If you need information about a specific drug or chemical, call:
For information about Fetal Alcohol Syndrome, alcohol and substance use, call:
Share information with all your health care providers.
Because of confidentiality issues, you can’t assume that the information you tell one health care provider will automatically
be shared with another. Mental health information cannot be shared unless you give signed consent. It’s your responsibility
to share information that affects the health of you and your baby with your doctor, lactation consultant and all other health
care providers. This includes information about alcohol, tobacco and any other prescription, over-the-counter medication or
illegal drug you may be taking.
What about cancer treatment?
For further information about cancer treatments such as chemotherapy and radiation while pregnant and breastfeeding, contact
a cancer treatment specialist or Motherisk.