Prescribing in Breastfeeding

Key points

• Most drugs pass into breast milk to some degree — check before prescribing.
• Generally safe: penicillins, cephalosporins, most SSRIs (sertraline preferred), ibuprofen.
• Contraindicated/caution: ciprofloxacin, tetracyclines, aspirin (Reye's risk), codeine (variable metabolism), lithium, cytotoxics.
• Timing feeds before dosing minimises infant exposure.