Search medications using Hale lactation risk categories (L1–L5). Get evidence-based guidance on which drugs are safe while nursing.
Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant.
Drug which has been studied in limited numbers of breastfeeding mothers without an increase in adverse effects in the infant.
There are no controlled studies in breastfeeding women, but evidence suggests the drug poses a minimal risk to the infant.
There is positive evidence of risk to a breastfed infant or a medication with no experience in breastfeeding women.
Studies in breastfeeding mothers have demonstrated that there is significant and documented risk to the infant based on human experience.
Most medications pass into breast milk in small amounts. The infant's dose is typically far lower than the mother's. Factors like drug size, lipid solubility, and binding affect transfer. Many drugs are effectively broken down by infant stomach acid or poorly absorbed.
Your pediatrician can assess whether a specific medication poses clinically significant risk.
Acetaminophen (L1) and ibuprofen (L2) are generally safe. Avoid naproxen (L3) and aspirin (L3) for long-term use. Check with your pediatrician for dosage.
Penicillins and cephalosporins (L1/L2) are safe. Tetracyclines (L3/L4) may discolor infant teeth. Fluoroquinolones vary (L2–L3). Discuss specific antibiotic with your doctor.
Sertraline and paroxetine (L2) are safer choices. Fluoxetine may accumulate (L2/L3). Discuss depression treatment with your provider—untreated depression harms bonding.
Progestin-only pills (L1) are safest while breastfeeding. Combined hormonal contraceptives (L2/L3) may reduce milk supply. Discuss timing and type with your provider.
Cetirizine (Zyrtec, L1) and loratadine (Claritin, L1) are safe. Avoid first-generation antihistamines (L2/L3) due to infant drowsiness. Decongestants may reduce supply.
LactMed is the National Library of Medicine's database of drugs and lactation. It provides detailed information on medication effects on breastfed infants and nursing mothers. Many healthcare providers consult LactMed for evidence-based recommendations. You can access it at lactmed.nlm.nih.gov.
Take medication shortly after nursing
Peak milk concentration occurs 1–3 hours post-dose for most drugs.
Request the lowest effective dose
Ask your provider if a lower dose or shorter duration is possible.
Avoid long-term or high-dose drugs when safer alternatives exist
Work with your provider to select medications with best safety profiles.
Monitor your infant for unusual signs
Drowsiness, poor feeding, rashes, or behavioral changes warrant discussion with your pediatrician.