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Breastfeeding: what is safe, what to avoid

The list is built from the Evigrade database: cosmetic ingredients tagged by lactation risk using AEMPS, e-lactancia.org and LactMed data; drugs mapped to breastfeeding clinical notes from FDA labels, EMA and the Russian Ministry of Health

Quick answer

Lactation safety is not yes/no but a risk-to-infant / benefit-to-mother balance. Most simple analgesics, penicillin and cephalosporin antibiotics, inhaled corticosteroids, and progestin-only contraception are compatible with continued breastfeeding. Cosmetics: retinoids, hydroquinone, oxybenzone and aluminum chlorohydrate carry documented risk and are avoided; most moisturizers, mild cleansers and mineral SPF are safe. For drug-specific decisions, e-lactancia.org is the recommended primary source.

Every entry links to the full card with citations.

Check a cream while breastfeeding →

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Ingredients to avoid during lactation

Ingredients with documented risk or insufficient safety evidence during breastfeeding. Some overlap with pregnancy avoid-list, some differ.

Use with caution

Ingredients that are applied on limited areas and short courses. Systemic absorption is possible, so a cosmetologist or dermatologist decides case by case.

Cosmetic ingredients safe during lactation

Cosmetic ingredients permitted while breastfeeding per AEMPS, e-lactancia.org and LactMed. Systemic absorption through skin is low for most INCI, and transfer through milk is minimal.

All ingredients in database →

Drugs: what the clinical notes say

Drugs with breastfeeding clinical notes extracted from FDA labels, EMA SmPC and the Russian Ministry of Health. For an individual decision, cross-check with e-lactancia.org and your prescribing clinician.

Fixed-dose combination: angiotensin II receptor blocker plus thiazide diuretic (6)
Fixed-dose combination: statin plus intestinal cholesterol absorption inhibitor (3)
Herbal sedative, EMA HMPC traditional herbal medicinal product (3)
HMG-CoA reductase inhibitors (statins) (3)
Inhaled corticosteroids (ICS) (3)
Mucolytic agent (3)
Non-steroidal anti-inflammatory drugs (NSAIDs) (3)
Other antivirals (local classification) (3)
Other immunostimulants (local classification) (3)
Other metabolic agents (local classification) (3)
Rapid-acting insulin analogue (3)
Second-generation antihistamine (5)
Statin (HMG-CoA reductase inhibitor) (3)
Triptan, selective 5HT1B/1D receptor agonist (4)
Other (663)

All drugs in database →

Frequently asked

Which drugs are clearly contraindicated during breastfeeding?

Strict contraindications include cytostatics (methotrexate, cyclophosphamide), ergotamine derivatives, amiodarone, lithium, radioactive iodine I-131, systemic isotretinoin and bromocriptine. Most antibiotics, simple analgesics, antihypertensives and psychotropics have compatible alternatives – check the specific INN on the drug card or on e-lactancia.org.

Is paracetamol safe during breastfeeding?

Yes. Paracetamol is the first-line analgesic and antipyretic during lactation. Compatible without restrictions per e-lactancia.org, LactMed and the WHO Model List of Essential Medicines.

Which cosmetic ingredients are avoided during lactation?

All retinoids (tretinoin, adapalene, retinol, retinaldehyde, retinoic acid, retinyl esters), hydroquinone, oxybenzone, octocrylene. Glycolic and salicylic acid above 2% are also avoided, especially on large areas. Mineral SPF based on titanium dioxide and zinc oxide is safe.

Can I drink alcohol while breastfeeding?

Ideally no. If an occasional drink is unavoidable (one glass of wine), nursing resumes 2-3 hours after a serving of 150 ml wine or 350 ml beer. Expressed milk is not “cleared” by pumping or by activated charcoal – ethanol in milk falls in parallel with maternal blood level.

What makes Evigrade different

Most lactation references cover drugs only. Evigrade checks drugs, supplements and cosmetics together in one system. This addresses real-life questions a nursing mother faces: “can I take this antibiotic for mastitis and is my niacinamide cream OK”, “is fish oil compatible with paracetamol”. Every ingredient and drug is tied to a primary source, and risk is shown explicitly rather than averaged.

Primary sources

e-lactancia.org (APILAM, free Spanish database), LactMed (NIH NLM, English), AEMPS CIMA, EMA SmPC, FDA Drug Label, Russian Ministry of Health clinical recommendations. Every card shows the source explicitly.

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