Medicines, alcohol, drugs and breastfeeding Ngā rongoā, te waipiro, ngā pūroi me te whāngai ū

You can keep taking most medicines while you are breastfeeding without harming your pēpi. It is best to talk to your healthcare provider, pharmacist or lactation consultant if you have any concerns.

Some medicines will pass into your breast milk. The amount your pēpi receives depends on:

• the type of medicine
• how your body absorbs it
• when you take it
• how old your pēpi is.

Premature and low-birthweight pēpi may be more affected by medicines you take than other pēpi.

There are lots of benefits of  breastfeeding your pēpi, and in most cases it is safe to continue while you take medicine.

Safely taking medicine while breastfeeding

Only use medicine when you need it, and when it is important to your health.

• It is safe to take paracetamol and ibuprofen while breastfeeding if you stick to the correct dose.
• Instead of cough and cold medicines, try saline nose drops, cool mist humidifier, or steam. Many cold remedies have a decongestant in them that can reduce your milk supply, so these should be avoided.

If you need to take medicine, there are ways you can reduce the exposure to your pēpi. 

• Take the lowest recommended dose for the shortest time possible.
• Avoid extra-strength or long-acting medicines with more than one active ingredient such as some cold remedies.
• Take the medicine in a form that reduces how much your milk absorbs. For example, it may be available as a cream, ointment or spray.
• Breastfeed when the medicine is at lower levels in your breast milk. One way to do this is to breastfeed just before taking it.
• Take the medicine before your baby's longest sleep period. This will minimise how much your pēpi gets and is useful for long-acting drugs that you take once a day.

Talk to your healthcare provider, pharmacist or lactation consultant if you have any questions or concerns.

You can check the drug factsheets on The Breastfeeding Network UK website for more information on breastfeeding and different types of drugs.

Drugs in Breastmilk factsheets — The Breastfeeding Network UK

If you need to stop breastfeeding

It is rare that you would need to stop breastfeeding altogether because of your medicines. Only in a very few cases is medicine too toxic to continue. For example, if you are having chemotherapy.

If you need to take a medicine that prevents you breastfeeding long-term, you will need to feed your pēpi another way.

You can read about formula feeding and ask your healthcare provider or lactation consultant to guide you.

Formula feeding — KidHealth

Recreational drugs (including cannabis) can harm your pēpi.

Because there is no control over the amount of active ingredients in recreational drugs, there is no way of knowing how much is in your milk. These drugs can stay in your baby's system for many hours. They can cause:

• sleepiness
• agitation
• breathing problems
• and potentially brain damage.

If you have taken a recreational drug, it is better to feed your pēpi another way — with stored or donated breast milk, or formula. 

After taking a recreational drug you may not be able to safely care for your pēpi. Make sure there is a responsible adult around to help you. 

When you drink alcohol, it is easily absorbed into your breast milk. The level of alcohol in your breast milk is about the same as in your blood.

Not drinking alcohol is the safest option for your pēpi if you are breastfeeding. But moderate drinking of up to one standard drink each day is not known to be harmful to babies,  especially if you wait at least 2 hours after one drink before breastfeeding. 

Drinking alcohol above moderate levels could be harmful to your baby's:

• development
• growth
• sleep patterns.

It can also impair your judgement and ability to safely care for your pēpi.

Planning feeds if you are drinking alcohol

Alcohol will pass into your breast milk 30 to 60 minutes after you start drinking. If you are planning to drink alcohol, you should plan this around your feeds.

• If you have one drink, it is best if you wait at least 2 hours before breastfeeding, when the alcohol will be out of your system.
• If you have 2 drinks, you should wait 4 hours to breastfeed.

You might choose to pump (express) and dump (throw away) your milk after drinking alcohol to ease any discomfort in your breasts. You can feed your pēpi with milk that you expressed earlier you when you had not been drinking.

Breastfeeding and alcohol — Plunket 

There are apps that can help you figure out when your breast milk will be free of alcohol.

Feed Safe app

It is best to stop smoking when you are breastfeeding because it affects you and your baby's health.

If you do smoke, it is much better for your pēpi to be breastfed than not to be breastfed at all. Breast milk helps to strengthen your baby’s immune system against infections that are more common in smoking households. These include chest and ear infections.

You can minimise the risk to your pēpi by:

• smoking after breastfeeding
• only smoking outside
• by using a smoking jacket.

A smoking jacket is a jacket that you put on when you are smoking and take off afterwards, then leave outside. This helps to reduce the amount of smoke on your clothes that your pēpi comes into contact with.

It is never too late to quit smoking for your pēpi. There are phone, web (blog), text and face to face services to help you to quit.

Call Quitline: 0800 778 778

Quitting smoking

Having a bit of caffeine every now and then is unlikely to cause problems for your pēpi. But it is best to avoid having a lot.

Caffeine is in:

• coffee and tea
• cola and energy drinks
• chocolate
• some herbal products
• some medicines.

In some cases, caffeine can make your pēpi irritable and change their sleep patterns.

Some pēpi, particularly those under 6 months, are more sensitive to caffeine. If your pēpi is bothered when you have even a small amount of caffeine, you might want to stop having any for a while to see if that makes a difference. Your pēpi will probably become less sensitive to caffeine as they get older.