Taking Medication While Pregnant or Breastfeeding

Brandel France DE Bravo, MPH, Melissa Stoner and Krista Brooks

Key Points

  • Some medications can cause birth defects and health problems in developing fetuses and babies.
  • You should always speak with a doctor before deciding to takemedications or vaccines while pregnant or breastfeeding.
  • Resources are available to find medications that are safe to take while pregnant or breastfeeding.

If you need to take medicine while you are pregnant or breastfeeding, you will probably have questions about which medications are safe for you to take, and which could possibly harm you and your baby.

Why does this matter?

If you are pregnant or breastfeeding and are planning to take a medication or get a vaccine, it is important to learn more about the possible risks and to discuss any potential side effects with your healthcare provider. It is also important to understand that your doctor may not know exactly what the risks are of certain prescription and over-the-counter medications. Some risks associated with medications have not been researched yet or might not be known by most doctors.

In addition, medications have a different impact when someone is pregnant. Medicines that you used to take may no longer be effective when you are pregnant, or the dose may need to be adjusted. Often, a different medication with less harmful effects can be taken for the same illness or health problem. Fortunately, many medications can be taken during pregnancy or breastfeeding without any negative effects. Unfortunately, not all medications have been carefully studied to determine their safety during pregnancy or breastfeeding.

How do I find out which medications are safe?

To learn about medications that might affect you and your child during pregnancy or breastfeeding, please view the links listed below.

  • MothertoBaby. This website publishes fact sheets on various exposures of concern, including medications. The information comes from experts at several universities. You can also consult with an expert through phone (866.626.6847), text (855.999.3525), live chat, or email.[3]
  • LactMed. This website has scientific information about medications and chemicals that a breastfeeding mother might wonder if she can pass on to her nursing infant. It is primarily for health professionals and parents who have scientific knowledge. LactMed is part of NIH’s National Library of Medicine(NLM).[4]

Which medications should I avoid while pregnant?

Some common medications have already been proven to be harmful to mother and infant when taken during pregnancy. The following is not a complete list. Review the above resources to search for specific medications and vaccines.

Pain Relievers. The following medications may cause decreased blood flow to the fetus when taken during the last 3 months of pregnancy (3rd trimester).[5] Aspirin has been shown to increase the risk of bleeding problems during labor.[6]

  • Ibuprofen (Advil and Motrin)
  • Naproxen (Found in Aleve)
  • Aspirin

Stomach-Ache

  • Bismuth subsalicylate (Pepto-Bismol) could potentially bleeding issues or birth defects.[8]

Cold/Cough. Medications containing guaifenesin (Mucinex and Robitussin) have a small chance of causing neural tube defects such as spina bifida in infants if taken during the first trimester of pregnancy.[9]

  • Guaifenesin (Mucinex and Robitussin)
  • Phenylephrine (Sudafed PE and Dayquil)[10]

Prescription Medication. The following medications can cause serious birth defects during pregnancy.

  • Accutane (commonly used for acne)[11]
  • Topamax (commonly used for migraines or epileptic seizures)[12]

Depending on the illness, there may be a safe alternative. While many common pain-relief medications pose risks, acetaminophen (Tylenol) is usually considered safe while pregnant or breastfeeding.[13] If you have any concerns about which medicines to take, it is best to first consult a doctor. Additionally, women taking herbal supplements or vitamins (other than recommended prenatal vitamins) should keep in mind that many of these products have not been tested for safety during pregnancy, so their potential harm is unknown.[14]

Medications while breastfeeding

Some people decide not to breastfeed because they are worried that medications they need to take will be passed on to their nursing infant through breast milk.  Fortunately, many medications are not passed through breast milk or have limited to no side effects on infants. Also, you can sometimes reduce the amount of medicine in breast milk by breastfeeding just before taking the medication.

Consider this guidance.

  • If the medicine is one that infants are sometimes prescribed, then the amount your baby will receive through your breast milk should not be of concern, as it will be far less than an infant dose of that same medicine.
  • Avoid using extra-strength or time-released versions of the medicine because these will stay in your body longer and therefore have a greater chance of being in your breast milk.
  • Not every medication you avoided in pregnancy you will need to avoid while breastfeeding. For instance, Ibuprofen is considered safe to take while breastfeeding. [7]

Postpartum depression, which lasts longer and is more serious than the “baby blues,” can affect a parent’s ability to care for their newborn. New parents who suffer from depression and want to breastfeed their baby should first try a type of “talk therapy” called cognitive behavior therapy because it is very effective for depression, stress, and the kinds of worries that new mothers often have. If therapy doesn’t start to help reduce the depression within eight weeks and you are continuing to breastfeed, talk to your doctor about which antidepressant medication poses the fewest risks to a nursing baby.

Other articles you might be interested in

Are Codeine Medications Too Risky for You or Your Children?

Exercising During Pregnancy: Anything Goes?

Helping Your Child Develop a Healthy Microbiome

Breastfeeding: The Finest Food for Your Infant Isn’t Sold in Any Store

All articles are reviewed and approved by Dr.Diana Zuckerman and other senior staff.

Footnotes

  1. Haas DM, Marsh DJ, Dang DT, et al. Prescription and other medication use in pregnancy. Obstetrics and Gynecology. 2018;131(5):789-798. doi:10.1097/aog.0000000000002579
  2. Office of the Commissioner. List of pregnancy exposure registries. U.S. Food And Drug Administration. Published July 11, 2025. https://www.fda.gov/consumers/pregnancy-exposure-registries/list-pregnancy-exposure-registries
  3. MotherToBaby. Contact Us with Questions or Concerns | MotherToBaby. MotherToBaby. Published June 16, 2025. https://mothertobaby.org/contact/
  4. National Institute of Child Health and Human Development. Drugs and Lactation Database (LactMed®). NCBI Bookshelf. Published 2006. https://www.ncbi.nlm.nih.gov/books/NBK501922/
  5. Price HR, Lai D, Kim H, Wright TE, Coughtrie MWH, Collier AC. Detection and quantitation of non-steroidal anti-inflammatory drug use close to the time of birth using umbilical cord tissue. Toxicology Reports. 2020;7:1311-1318. doi:10.1016/j.toxrep.2020.09.003
  6. Jiang Y, Chen Z, Chen Y, et al. Low-dose asprin use during pregnancy may be a potential risk for postpartum hemorrhage and increased blood loss: a systematic review and meta-analysis. American Journal of Obstetrics & Gynecology MFM. 2023;5(4):100878. doi:10.1016/j.ajogmf.2023.100878
  7. National Institute of Child Health and Human Development. Ibuprofen. Drugs and Lactation Database (LactMed®) – NCBI Bookshelf. Published June 15, 2025. https://www.ncbi.nlm.nih.gov/books/NBK500986/
  8. Nall R. Is it safe to take Pepto-Bismol during pregnancy? Published December 18, 2023. https://www.medicalnewstoday.com/articles/322959#safety-during-breastfeeding
  9. Cao Y, Rhoads A, Burns T, et al. Maternal use of cough medications during early pregnancy and selected birth defects: a US multisite, case–control study. BMJ Open. 2021;11(12):e053604. doi:10.1136/bmjopen-2021-053604
  10. Organization of Teratology Information Specialists (OTIS). Phenylephrine. MotherToBaby | Fact Sheets – NCBI Bookshelf. Published September 1, 2024. https://www.ncbi.nlm.nih.gov/books/NBK582906/
  11. Organization of Teratology Information Specialists (OTIS). Isotretinoin (Accutane®). MotherToBaby | Fact Sheets – NCBI Bookshelf. Published October 1, 2023. https://www.ncbi.nlm.nih.gov/books/NBK582775/
  12. Research C for DEA. FDA Drug Safety Communication: Risk of oral clefts in children born to mothers taking Topamax (topiramate). U.S. Food And Drug Administration. Published February 7, 2018. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-risk-oral-clefts-children-born-mothers-taking-topamax-topiramate
  13. National Institute of Child Health and Human Development. Acetaminophen. Drugs and Lactation Database (LactMed®) – NCBI Bookshelf. Published June 15, 2025. https://www.ncbi.nlm.nih.gov/books/NBK501194/
  14. Sarecka-Hujar B, Szulc-Musioł B. Herbal Medicines—Are They Effective and Safe during Pregnancy? Pharmaceutics. 2022;14(1):171. doi:10.3390/pharmaceutics14010171