Breastfeeding Food and Medicine Safety
While breastfeeding, eat a varied diet and check each medicine with a pharmacist or clinician.
SUMMARY
Do not stop a prescribed medicine without talking to your prescriber.
Tell the pharmacist what you take, your baby’s age, and whether your baby was premature or had jaundice at birth.
Everyday meals, without a forbidden-food list
Build meals from grains or other starchy foods, vegetables, fruit, protein foods, and dairy or suitable fortified alternatives.
You can eat peanuts while breastfeeding unless you are allergic to them.
If you suspect a food allergy in your baby, seek medical advice before cutting foods out of your own diet.
If you avoid animal foods, ask a clinician about vitamin B12 and other nutrient needs and supplements.
Choose fish by type
Salmon, sardines and shrimp are examples of lower-mercury “Best Choices” in US guidance.
Under US guidance, breastfeeding adults can eat 2–3 servings a week from “Best Choices”; one adult serving is 4 oz before cooking.
If you choose a “Good Choices” fish, eat only one serving and no other fish that week; avoid “Choices to Avoid” such as swordfish and king mackerel.
Coffee, tea and total caffeine
UK guidance recommends no more than 200 mg of caffeine daily; US CDC guidance describes about 300 mg or less as low to moderate intake.
For a cautious starting limit, keep total caffeine at 200 mg a day or less, including coffee, tea, chocolate and energy drinks.
Young newborns and premature babies clear caffeine more slowly, so consider less; reduce intake if your baby seems unusually fussy or irritable after high intake.
Caffeine content varies by product and preparation, so check the amount rather than relying only on cup count.
If you are considering alcohol
Avoiding alcohol is the safest choice while breastfeeding.
CDC does not recommend more than one US standard drink per day while breastfeeding. If you drink, wait at least 2 hours after one drink before breastfeeding; more drinks require a longer wait.
A US standard drink contains 14 g of pure alcohol, and a large or strong drink can count as more than one.
Pumping and discarding milk does not clear alcohol faster; if a feed is needed while waiting, use milk expressed before drinking.
If you are intoxicated, have a sober adult care for your baby.
Check the ingredient before taking medicine
Most medicines have little or no effect on milk supply or the breastfed baby, but some need an alternative or an individual feeding plan.
| Medicine or product | What to check |
|---|---|
| Paracetamol / acetaminophen | Paracetamol, also called acetaminophen, is usually a preferred painkiller while breastfeeding. |
| Ibuprofen | Ibuprofen can often be used if needed, after checking with a pharmacist or doctor that it is suitable for you. In particular, mention stomach ulcers, kidney disease or a past reaction to ibuprofen or aspirin before using ibuprofen. |
| Antibiotics and asthma inhalers | Most antibiotics and asthma inhalers can be used while breastfeeding; confirm your specific product rather than stopping treatment yourself. |
| Codeine and oral decongestants | Avoid codeine and oral decongestants while breastfeeding, and ask a pharmacist for a suitable alternative. |
| Aspirin | Aspirin for pain relief is usually not recommended; prescribed low-dose aspirin for blood clots needs a separate decision with your doctor. |
| Herbal and allergy products | Herbal remedies are not automatically safe, and allergy medicines and nasal decongestant sprays need a product-specific check. |
Do not combine paracetamol with another product that contains it, including a cold-and-flu remedy.
Show the medicine packet and all other medicines or supplements to your pharmacist, and follow the agreed dose and product instructions.
Your clinician or pharmacist can use LactMed, a medicine-and-breastfeeding database, to check infant effects and possible alternatives.
When your baby needs help
If you have taken codeine by mistake, do not take another dose and seek prompt medical advice about your baby and feeding.
Get medical help immediately if your baby becomes unusually sleepy or has difficulty feeding after you take codeine.
Call your local emergency number immediately for breathing difficulty, a baby who cannot be woken, or limpness and poor responsiveness.
Practical questions
Can I have dental treatment?
Routine dental treatment and local anaesthetics are compatible with breastfeeding; tell your dentist that you are breastfeeding.
Should I wait a fixed number of hours after every medicine?
There is no single waiting time for every medicine: ask about the exact drug, your baby’s age and how much breast milk your baby receives.