MEDICATION IN LACTATION
There are few maternal medications that would cause a mother to stop breastfeeding (see contraindications page). NICE Guidance recommends that health professionals prescribing for breastfeeding mothers must consult supplementary sources on the benefits and risk (rather than relying on the British National Formulary, which does not at present contain sufficient data to base individual decisions)
Please look at these trusted resources before advising any mother to stop breastfeeding due to medication:
UKDILAS - this is an NHS advisory service on lactation and drugs. Specialist lactation information is available on individual drugs - search for the drug and then scroll right down to the bottom to see the lactation section (or click on the 'lactation safety information' hyperlink to jump straight there). There are also topic reviews and Q&As on broader classes of medication. Health professionals can contact the enquiry service in working hours on 0116 258 6491, 0121 4247298, or @ukdilas. Of particular relevance are the information sheets on:
LactMed - this is a searchable database from the US National Library of Medicine
The Royal College of Radiologists includes breastfeeding in their guideline on gadolinium-based contrast, stating that a very small percentage of the injected dose enters breastmilk and virtually none is absorbed by a normal infant gut - therefore no special precaution or cessation of breastfeeding is required related to gadolinium-based contrast. The Royal College of Radiologists also endorses the Royal Australian and New Zealand College of Radiologists' guideline on iodenated contrast agents, which states that "cessation of breast feeding or expression and discarding of breast milk after iodinated contrast media administration are not required"
The Academy of Breastfeeding Medicine has protocols on analgesia and anaesthesia, and substance misuse, amongst others
The Breastfeeding Network (BfN) medication factsheets and the Drugs in Breastmilk Helpline - compiled and run on a voluntary basis by Dr Wendy Jones, who has been awarded a Prime Minister's "Points of Light" award and an MBE for this work. Mothers and health professionals can email or message on the Facebook page. Of particular relevance are the factsheets on:
The Royal College of Obstetrics & Gynaecology has issued specific guidance on codeine in breastfeeding mothers, which recommends that dihydrocodeine should be used in preference due to the risk of opiate toxicity to the newborn in some mothers taking codeine. This information is taken from the UKDILAS Q&A on weak opiates
Also see our resources for HIFN campaign 'Don't Say Stop Look it Up'