Breastfeeding and Drugs In Breast Milk: What Pharmacists Need To Know

Breastfeeding is one of the most important things a mother can do for her baby but what about the concerns around drugs in breast milk? And why do 80% of mothers in the UK prematurely stop breastfeeding?

Since many women have to take medication for certain conditions, they may be unsure whether it is safe to continue breastfeeding or whether they should opt for formula. Some may refrain from taking any medication for a number of conditions which could negatively impact their own health.

This guide aims to help community pharmacies better understand the concerns about drugs in breast milk, the benefits of breastfeeding and how to counsel mothers more effectively.

What Are The Benefits Of Breastfeeding?

Pharmacists play an important role in helping mothers to not only understand the risks around drugs in breast milk but also the overwhelming benefits of breastfeeding. Some of the main advantages of breastfeeding are as follows:

  • Breast milk is uniquely designed for each mother and baby pair
  • It is a natural, convenient and cost-effective way to feed a baby.
  • Breast milk provides babies with high levels of protection against infections and diseases
  • Breastfeeding provides health benefits to the mother as well
  • Breast milk is readily available (unless there is a preexisting medical condition where mothers struggle to produce sufficient amounts – Mammary hypoplasia)
  • Breastfeeding can build a strong emotional bond between the mother and their baby
  • Lowers the baby’s risk of developing allergies, diabetes, and other chronic conditions
  • It may reduce the mother’s risk of developing certain cancers, osteoporosis, and other health problems

Breastfeeding Or Formula?

Breast milk provides essential nutrients that are important for a baby’s development while the antibodies help protect the baby from illnesses and infections. However, some mothers may not be able to breastfeed or choose not to in which case formula may be a good alternative.

Although formula is a manufactured product backed by science and contains loads of nutrients, they aren’t absorbed as easily as those found in breast milk. Most formulas are made with cow’s milk, but there are also options available with soy-based or other plant-based formulas with added iron which helps reduce anaemia risk in infants.

No matter which option a mother chooses, the most important thing is that the baby receives adequate nutrition and that mothers consult with a pharmacist, paediatrician or doctor if they have any questions or concerns about drugs in breast milk or the use of formula.

Is It Safe To Breastfeed While On Medication?

It’s important for pharmacists to utilise the available information on drugs in breast milk, the levels of medicines that pass through breast milk to the baby, the potential for adverse effects in the infant, and whether there are alternative medications the mother could be using.

While many drugs do pass into breast milk in small amounts, not all medicines pose a threat to the baby. However, patients should always consult their doctor or pharmacist before taking any medication while breastfeeding as this is the only way they can make a more informed decision. A great resource to see the compatibility of over 35,000 medications is e-lactancia.

Compatibility check for drugs in breast milk

Which Drugs Should Not Be Taken When Breastfeeding?

Many breastfeeding mothers are understandably concerned about drugs in breastmilk but not all medicines are bad. In fact, only a few drugs can impact breastmilk and pose a clinically significant risk to babies and generally include the following:

  • Anticancer drugs
  • Antineoplastics
  • Drugs of abuse (heroin, cocaine, hallucinogens)
  • Some anticonvulsants
  • Ergot alkaloids (a group of medicines used for migraines and cluster headaches)
  • Radiopharmaceuticals
  • Lithium
  • Oral retinoids
  • Iodine

Whilst most medicines can be taken safely while breastfeeding, and for those few that are a safety issue, there are often acceptable substitutions. It’s a pharmacist’s duty to provide patients with the right guidance and provide safer alternatives where needed.

Drugs In Breast Milk Service

For those who have ingested street drugs or may be considering them, please reach out to the Drugs in Breastmilk Service for advice on breastfeeding safely and effectively. Volunteers at NBH and BfN helplines can refer patients to pharmacists so that they can provide further assistance while supervision is available if needed.

The Breastfeeding Network (BfN) works tirelessly to offer mothers the necessary information they need to breastfeed their babies for as long as desired. They also deliver important data on medicine safety that is tailored specifically to each mother and baby. As a pharmacist, it is your duty to provide patients with the right information and these resources can help:

Understanding Drugs In Breast Milk: Guidance For Pharmacies

By understanding the potential risks, pharmacists can offer appropriate advice to mothers and reassure them that they are making the right decision for their babies. The key is not only being able to identify potential risks but also helping mothers weigh them against the potential benefits of continuing to breastfeed so that they can make an informed decision for their baby.

It is also important for community pharmacies to understand that there is a range of factors which may influence whether or not a mother decides to breastfeed, including cultural attitudes and beliefs. As such, it is important that pharmacists are equipped with the knowledge and understanding necessary to effectively counsel mothers on the risks posed by drugs in breast milk.

How Can Pharmacists Help Improve Breastfeeding Uptake?

Despite the proven benefits of breastfeeding and a national drive to increase breastfeeding rates, the UK still has some of the lowest breastfeeding rates in the world. This is where pharmacists can play an important role as they can help change the perception about breastfeeding and drugs in breast milk.

Pharmacies teams can support mums in a number of ways including promoting and signposting parents to information and support from organisations like the NHS, The Breastfeeding Network (BfN) and the Hospital Infant Feeding Network (HIFN). Community pharmacies can also provide

  • guidance to mothers who are breastfeeding and need to take medication
  • advice on which medications are safe to take while breastfeeding and which to avoid
  • information on the possible side effects of the medication on the baby and the mother
  • mothers with an alternative treatment option if the medication is unsafe for breastfeeding
  • information on how to monitor the baby for any signs of side effects from potential drugs in breastmilk

Conclusion: Drugs In Breast Milk

It is important for pharmacists to remember that every mother and baby is different and that there is no one-size-fits-all answer when it comes to breastfeeding and medication. They should not simply tell mothers to stop breastfeeding, but rather provide them with the guidance and information they need to make an informed decision.

Sometimes it is necessary for a mother to take medication that is not safe for the baby, and in this case, she may need to temporarily suspend breastfeeding until her treatment has finished. If this is the case, the mother should follow any advice given by her healthcare provider and seek additional support from a lactation consultant if necessary.

As always, VirtualOutcomes is here to support all pharmacy teams better serve their communities and help patients understand drugs in breast milk among other important topics. Visit our website for more information and to access the latest training module – Drugs in breast milk. Please follow our blog for all the latest updates.