Medication and donating breastmilk

UKAMB would like to thank Wendy Jones, MRPharmS, of the Breastfeeding Network for her expert advice in compiling this information.

All drugs have the potential to pass into breastmilk in varying amounts, depending on the way the body handles the drug. In general only small quantities reach babies and term, fit and well babies can continue to be breastfed in the vast majority of circumstances.

Why can’t I donate my milk but I can carry on breastfeeding my own baby?

Babies who will receive donor breastmilk are normally very premature and may well be poorly, so it is essential that the milk is as pure as it can be and free of any drug which may impact on the baby receiving it. The babies are also very vulnerable because their livers and kidneys, which have to deal with any drug to which they are exposed, are still very immature and not fully functioning. All babies born at term are more susceptible to drugs in the first 6 weeks of their life, a period in which we are careful about what drugs we use. Premature babies are vulnerable for much longer. It is also important that they don’t receive anything which may interact with medicines which they may be given directly.

We need to avoid any drugs:

Over-the-counter drugs which you can take and continue to donate:

Please check with the milk bank before donating after taking any medicine which you buy from a supermarket or pharmacy even if they appear on the list below. and always write on the label of your breastmilk container any medications taken in the 24 hours prior to expressing even if on the accepted list:

Over the counter medicines which you should NOT take when you are donating but can be taken when feeding your own baby:

Prescribed medicines which you may be able to take and still become a breastmilk donor:

Even if your GP has confirmed that you can continue to breastfeed your own baby, you should inform the milk bank of any medication you have been prescribed before continuing to donate, even if the medication is on the following list:

Prescribed medicines which you should NOT take when you are donating but can be taken when feeding your own baby:

Many people assume that a herbal remedy is not a medicine because it is “natural”. In fact many products can and do produce significant actions and thus side effects. Please check with your milk bank before taking any herbal remedies whilst donating.

Herbs which you should not take whilst donating:

Herbal fruit teas can be drunk in normal quantities. Use of any herbs should be discussed with the milk bank. All herbs have therapeutic effects, which may not be appropriate for a preterm baby. Please seek information from your milk bank if you drink any product which may result in transfer into breastmilk.

Treatments

The following beauty treatments can be enjoyed whilst donating breastmilk:

But donating after tattoos should be AVOIDED in case of the remote risk of acquiring an infection.

Injections and blood products

 

Where to get more information

Please check with the milk bank to whom you are donating about any medication which you take before donating the milk and until then label your container with the drug you have taken and dose. Further information can be obtained from:

The Breastfeeding Network Drugs in Breastmilk Helpline 0844 412 4665
www.Breastfeeding-and-medication.co.uk
Medicines Information at Local Hospital
Regional Medicines Information Services (UKMI)

 

Frequently asked questions

Which painkillers can I take whilst I am donating breastmilk?
Whilst donating you should only take paractamol ( up to 8 x 500mg tablets in 24 hours). If you need to take any other medication e.g. ibuprofen, codeine, tramadol you should stop donating until 24 hours after you have stopped the tablets. You can continue to breastfeed your own child whilst taking all of these drugs but we cannot expose premature babies to a drug which may increase the risk of drowsiness or respiratory problems.

I would really like to donate breastmilk, but at the moment I am taking an antidepressant. If I stop taking my drug how long must I wait before I can donate?

It is really not a good time to try to stop taking antidepressants immediately after giving birth. This is a very stressful time with little opportunity to sleep. If you stop your medication now, you may find your mood drops quickly. Although donating your breastmilk may sound, and is, a really wonderful thing to do, you need to take care of yourself and your baby first. Maybe you can fundraise for the special care baby unit or find a different way to support mothers and babies.

I have been taking domperidone to increase my milk supply and now I have more milk than my baby needs, can I donate the excess to the milk bank?

It is really good to hear that you now have a good milk supply but unfortunately you cannot donate your milk. Although very little domperidone passes into breastmilk, it is a drug which cannot be given to babies who have any heart problems. It is not possible to label all milk with any drugs which may be present so we cannot accept milk which may have even a trace of domperidone. Similarly fenugreek, a herb used to increase breastmilk supply, has several interactions and cannot be given to premature or sick babies other than via their own mother’s milk where we are aware of what she is taking.

I need to have minor (day) surgery. When can I start to donate again?

General anaesthetics have a very short half life in the body, and it is usually safe to breastfeed your own baby very soon after surgery. The Breastfeeding Network has a useful information sheet to help mums in this situation (click here). However, because of the small amounts of anaesthetic that will take a little longer to leave the body, which would be fine for a healthy, term baby (although they may make him a little sleepy), it is important to wait for 72 hours after surgery before donating milk to a milk bank, as trace amounts of the drugs may affect tiny, premature babies more seriously, or interfere with the drugs they’re already being given.