Miralax, Dulcolax, and Other Medications Safe to Use While Breastfeeding

What medicines are safe to use while breastfeeding? Stool softeners like Miralax or Dulcolax? Acid blockers like Zantac or Pepcid? What about anti-inflammatory medications or antibiotics?

To help answer your questions, we put together a list of commonly used medications, along with safety considerations during breastfeeding. If you need additional information, the National Library of Medicine is an excellent resource concerning any additional medications.

We’ve also put together a great list of additional articles and resources covering the top breastfeeding issues.

1) Acid blockers (Zantac, Pepcid, Prilosec, Protonix, Nexium):  Acid blockers are not found in any significant levels in breast milk and are considered safe.  In fact, Pepcid and Zantac are commonly used by pediatricians for babies.

2) Stool softeners and laxatives (Miralax, Dulcolax, Colace, Surfak):  Stool softeners are safe because they are not absorbed through the intestines to any extent, and therefore are not found in breast milk.

3) Anti-inflammatory medications (fever and/or pain):

Advil, Motrin, Ibuprofen:  These are anti-inflammatory medications of choice. There are no known problems for baby due to extremely low levels found in breast milk, much lower than amounts used for babies by pediatricians.

Aleve, Naproxen: These medications are less commonly used while breastfeeding because they are longer acting. There are no serious complications noted with Naproxen, and levels are extremely low in breast milk, but studies are limited.

Acetaminophen:  Good choice!  Extremely minimal amounts released in breast milk; Used in much lower amounts than commonly used by pediatricians in infants.

4) Cold and Allergy Medications (Decongestants, Anti-Histamines):

Ephedrine (Pseudoephedrine):  Found in cold and sinus medications, it’s probably safe, but may cause mild reductions in breast milk production. Because of that, it should be taken with caution if you’re having difficulty with production. Pseudoephedrine can also cause some minor irritability in the baby.

Antihistamines (Benadryl, Diphenhydramine, Claritin, Zyrtec):  These are all relatively safe during breastfeeding. However, they may cause drowsiness in the baby and may also result in decreased milk production, especially when used with pseudoephedrine (a combination typically found in cold medications).

E) Narcotic Pain medications, hydrocodone (Norco, Tylenol #3, Vicodin):  These are safe for breastfeeding in smaller doses.  They can cause significant drowsiness and can have significant effects on baby’s ability to breastfeed.  It is recommended to limit the doses used. The National Library of Medicine recommends keeping the dosage below 30mg /day, which is equivalent to six 5 mg tabs per day.

F) Birth Control Pills:  Are considered safe for breastfeeding.  Combination pills that have both estrogen and progesterone are more likely to reduce breast milk production, therefore progesterone-only pills are suggested during breastfeeding.

G) Antibiotics (Penicillins, Cephalosporins, Erythromycin, Clindamycin):  Considered safe in breastfeeding but can potentially cause diarrhea in the baby.

As always, it’s a good idea to check with your health care provider before you take medications if you’re breastfeeding. It’s also recommended that you try to stay away from anything that’s not absolutely necessary, like vitamins with high-doses, herbal medications, or uncommon supplements.