{"id":5350,"date":"2019-08-08T09:00:13","date_gmt":"2019-08-08T13:00:13","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=5350"},"modified":"2021-04-16T14:54:55","modified_gmt":"2021-04-16T18:54:55","slug":"alcohol-medications-when-breastfeeding","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/alcohol-medications-when-breastfeeding\/","title":{"rendered":"What really makes it into your breast milk?"},"content":{"rendered":"<p><em>This is part of a series on breastfeeding in support of National Breastfeeding Month (August). Find the full coverage\u00a0<\/em><a href=\"https:\/\/www.singlecare.com\/blog\/tag\/breastfeeding\/\"><em>here<\/em><\/a><em>.<\/em><\/p>\n<p><span style=\"font-weight: 400;\">Nursing moms know that everything you put into your body has the potential to affect your baby through your breast milk. You strive for good nutrition and hydration to feed your little one the best food possible.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But what about the non-food things that you consume? Specifically, prescription medications and alcohol. Are they safe for nursing mothers to take? How much of these substances make their way into your milk? We checked in with some experts to find out.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Prescription medications when breastfeeding<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Is it safe to take prescription <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/antidepressants-breastfeeding-nursing-moms\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">medications when breastfeeding<\/span><\/a><span style=\"font-weight: 400;\">? The simple answer is usually. According to a <\/span><a href=\"http:\/\/pediatrics.aappublications.org\/content\/132\/3\/e796\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">clinical report by the American Academy of Pediatrics<\/span><\/a><span style=\"font-weight: 400;\">, most medications and immunizations are safe to use during lactation and will not harm your baby.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cMost standard medications are safe for a healthy baby [when taken by the breastfeeding mother],\u201d says Rachael Martin, a registered nurse in Bowie, Maryland. She goes on to say that many physicians, pediatricians, and pharmacists don&#8217;t have enough information about medications and breastfeeding, so it&#8217;s best to speak with a lactation consultant or educator who specializes in this.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">And, of course, not all medications are created equal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cMedications vary tremendously depending on the kind of drug and its chemical makeup,\u201d says Kelly Kendall, a registered nurse and lactation consultant in Crofton, Maryland.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This means that your healthcare provider will have to weigh the benefits and risks of each individual medication before prescribing it to breastfeeding mothers. According to the AAP report, some factors to consider are:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">the mother\u2019s need for the drug.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">the potential effects of the drug on milk production.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">the age of the infant.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">how many breast milk feedings the baby receives per day.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">the amount of the drug excreted into breast milk.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">the extent of oral absorption by the breastfeeding infant.<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">any potential adverse effects on the breastfeeding infant.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Let\u2019s take a closer look at those last three bullet points. How can you know how much of a medication is excreted into the breast milk, and then absorbed by your baby? And most importantly, how will you know if the medication can cause your baby any harm?<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cIt depends on the medication and how it is metabolized and excreted, as well as what its half-life is,\u201d Martin says. \u201cThe safety of a drug for breastfeeding has been researched most thoroughly by Dr. Thomas Hale.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Hale\u2019s book, <\/span><a href=\"https:\/\/www.amazon.com\/gp\/product\/0826128580\/ref=as_li_tl?ie=UTF8&amp;camp=1789&amp;creative=9325&amp;creativeASIN=0826128580&amp;linkCode=as2&amp;tag=kellysattachm-20&amp;linkId=4a9506687976e47fdaceca93f240f1fe\" target=\"_blank\" rel=\"noopener noreferrer\"><i><span style=\"font-weight: 400;\">Medication and Mother\u2019s Milk<\/span><\/i><\/a><span style=\"font-weight: 400;\">, co-authored with Dr. Hilary E. Rowe, Pharm.D., is currently in its 17th edition. It is considered the premiere resource on medication safety while breastfeeding.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The authors assign a lactation risk category (LRC) to a wide variety of drugs using a number of factors. First, they determine the drug\u2019s overall toxicity. Some drugs have low toxicity, like penicillins, sulfas, and NSAIDs (such as ibuprofen). But others are highly toxic, such as cancer drugs and antimetabolites. Often, there are not controlled studies available to provide breast milk data on the drug. In this case, the authors rely on the drug\u2019s pharmacokinetics, which includes its oral absorption, plasma levels, and half-life. Using this information, the authors make an educated estimate of its LRC.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It would be impossible for us to break down all of these factors for every possible prescription medication in a single blog post. However, you can find information about specific drugs at the <\/span><a href=\"http:\/\/www.infantrisk.com\"><span style=\"font-weight: 400;\">Infant Risk Center<\/span><\/a><span style=\"font-weight: 400;\">, another project of Dr. Hale\u2019s. The center provides a hotline you can call with questions about medication safety during lactation.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Alcohol and breastfeeding<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">When it comes to <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/breastfeeding-maternal-mental-health\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">alcohol and breastfeeding<\/span><\/a><span style=\"font-weight: 400;\">, the answers are a bit different. \u201cMothers can enjoy drinking in moderation,\u201d Kendall says. \u201cA good rule of thumb is if you are sober enough to drive, you are fine to breastfeed.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many experts, including the <\/span><a href=\"https:\/\/pediatrics.aappublications.org\/content\/129\/3\/e827.full#content-block\"><span style=\"font-weight: 400;\">American Academy of Pediatrics<\/span><\/a><span style=\"font-weight: 400;\"> and the <\/span><a href=\"https:\/\/www.cdc.gov\/breastfeeding\/breastfeeding-special-circumstances\/vaccinations-medications-drugs\/alcohol.html\"><span style=\"font-weight: 400;\">Centers for Disease Control and Prevention<\/span><\/a><span style=\"font-weight: 400;\">, recommend that nursing mothers consume no more than one to two alcoholic beverages per week (and they state that not drinking at all is safest, of course). Nursing should occur two or more hours after alcohol consumption, to minimize exposure to the baby. But the research on this subject is conflicting.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cAlcohol is metabolized in breast milk at the same rate as it is through blood,\u201d Martin says. In other words, if your blood alcohol content is 0.08% after drinking three glasses of wine, which would put you over the legal limit for driving in most states, then your breast milk is also 0.08% alcohol.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For comparison purposes, each of those glasses of wine was probably 10-20% alcohol. So the milk your baby is drinking has significantly less alcohol than your beverage. In fact, according to a clinical review in the journal <\/span><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/bcpt.12149\" target=\"_blank\" rel=\"noopener noreferrer\"><i><span style=\"font-weight: 400;\">Basic Clinical Pharmacology and Toxicology<\/span><\/i><\/a><span style=\"font-weight: 400;\">, the amount of alcohol consumed by nursing babies through breast milk is approximately 5\u20136% of the amount the mother drinks. \u201cEven in a theoretical case of binge drinking, the children would not be subjected to clinically relevant amounts of alcohol,\u201d according to the study. \u201cNewborns metabolize alcohol at approximately half the rate of adults.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Contrary to popular belief for many years, there is no need to \u201cpump and dump.\u201d Just as alcohol passes into your breast milk, it also passes <\/span><i><span style=\"font-weight: 400;\">out<\/span><\/i><span style=\"font-weight: 400;\"> at the same rate as it does from your blood. As your blood alcohol content comes down, so does the alcohol content of your milk. If you think you\u2019ve had too many drinks to nurse your baby, just wait a bit (usually two to three hours should suffice) while you sober up. And don\u2019t dump out that liquid gold!<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have any questions about the safety of alcohol or prescription medications when breastfeeding, talk to a lactation counselor, your OB-GYN, or your child\u2019s pediatrician<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>This is part of a series on breastfeeding in support of National Breastfeeding Month (August). Find the full coverage\u00a0here. Nursing moms know that everything you put into your body has the potential to affect your baby through your breast milk. You strive for good nutrition and hydration to feed your little one the best food [&hellip;]<\/p>\n","protected":false},"author":85,"featured_media":8810,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[8742,8970,788],"coauthors":[8859],"class_list":["post-5350","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-alcohol-interactions","tag-breastfeeding","tag-drug-safety","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.8 (Yoast SEO v27.8) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Can you drink alcohol or take medications when breastfeeding?<\/title>\n<meta name=\"description\" content=\"It depends. It&#039;s safe to take many \u2014but not all\u2014 medications when breastfeeding. 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