Medication			Safety recommendation	Possible effect on infant
Analgesics
	Acetaminophen, ibuprofen (Motrin), opioids		Safe in commonly prescribed doses	—
	High-dose aspirin		Second-line option	Platelet dysfunction; one case of metabolic acidosis
	Meperidine (Demerol); naproxen (Naprosyn)		Use with caution	Long half-life may lead to accumulation in infant
Antibiotics
	Aminoglycosides		Safe	—
	Cephalosporins		Safe	—
	Fluoroquinolones		American Academy of Pediatrics considers safe	Possible risk of arthropathy
	Macrolides		Use with caution	Erythromycin associated with increased incidence of pyloric stenosis
			Concentrated in human milk
	Metronidazole (Flagyl)		Pump and discard breast milk during use and 24 hours after last dose	In-vitro mutagen; no association with cancer seen in humans
	Nitrofurantoin (Furadantin)		Use with caution	Hemolysis in infant with G6PD deficiency
	Penicillins		Safe	—
	Sulfa drugs		Avoid use in first month	Elevates infant bilirubin levels
	Tetracycline		Avoid prolonged use (greater than three weeks)	Tooth staining
Antihypertensives
	Angiotensin-converting enzyme inhibitors		Safe after four to six weeks	Possible renal toxicity in premature infants
	Beta blockers		—	—
		Atenolol (Tenormin)	Do not use	Cyanosis, bradycardia
		Other beta blockers	Use with caution	Bradycardia
	Calcium channel blockers		Use with caution	—
Antidepressants
	Fluoxetine (Prozac)		Weigh risks versus benefits	May cause colic, irritability, feeding and sleep disorders, slow weight gain
	Sertraline (Zoloft), paroxetine (Paxil)		Excreted in breast milk, but infant serum levels very low or undetectable	No reported effect
Combined oral contraceptives			Avoid until breastfeeding well-established (60 to 90 days); low dose preferred	May decrease milk supply