General considerations

Avoid drug therapy when possible.

Use topical therapy when possible.

Medications that are safe for use directly in an infant of the nursing infant's age are generally safe for the breast-feeding mother.

Medications that are safe in pregnancy are not always safe in breast-feeding mothers.

Use reliable references for obtaining information on medications in breast milk.

Medication selection

Choose medications with the shortest half-life and highest protein-binding ability.

Choose medications that are well-studied in infants.

Choose medications with the poorest oral absorption.

Choose medications with the lowest lipid solubility.

Medication dosing

Administer single daily-dose medications just before the longest sleep interval for the infant, usually after the bed-time feeding.

Breast-feed infant immediately before medication dose when multiple daily doses are needed.