Medications used to treat gastrointestinal symptoms are increasingly being used as more have been gained nonprescription status. Most of the gastrointestinal medications, such as laxatives,
antacids, and
antidiarrheal agents, are used short term. Women who breastfeed should be aware of the risks of taking any medications, whether prescription or nonprescription. There is little information describing transfer into breast milk for many of these products.
Cimetidine,
atropine, cascara,
cisapride,
loperamide,
magnesium sulfate, and senna are the only products identified by the
AAP as compatible with breast feeding.
Metoclopramide is listed by the
AAP as a
drug whose effect on nursing infants is unknown but may be of potential concern, although studies published to date have not reported any adverse effects. The safest laxatives and
antidiarrheals are those that are not absorbed and should be considered first-line
therapy for conditions of
constipation or loose stools.
Famotidine and
nizatidine are excreted into breast milk to a lesser extent than
cimetidine or
ranitidine and may be the preferred
histamine antagonists. Despite the limited data on the use of
cisapride in nursing women, it is considered safe by the
AAP and may be preferred over
metoclopramide for first-line prescription treatment of
heartburn. Although most of these agents appear safe in the nursing infant, caretakers should be aware of the potential adverse reactions that may occur in infants whose mothers require these products.