Mums may be able to take more medicines while breastfeeding MOTHERS are being wrongly told to stop breastfeeding or avoid taking medicines because of fears they will harm their baby, a US expert says. Paediatrician Hari Cheryl Sachs says only a small number of medicines are not recommended for breastfeeding mothers. In an article published in the American Academy of Paediatrics, she says not all drugs are excreted in clinically significant amounts in human milk. And even when a medicine is present in breast milk, it may not be a problem for the baby. Many non-steroidal anti-inflammatory drugs like celecoxib, used for arthritis, and naproxen are compatible with breast feeding because less than one per cent is excreted into human milk, the article says. Low doses of aspirin (75-162mg) can be used but high-dose aspirin during breast feeding has been linked to rashes, blood abnormalities and bleeding, she says. Nicotine replacement therapy is compatible with breastfeeding, the article says, as long as the dose is less than the number of cigarettes typically smoked because nicotine passes freely into human milk. However, while they are worried about pharmaceuticals and breastfeeding, many mothers were unaware herbal medicines could also be an issue. Products like kava and yohimbe have been associated with liver damage and infant death and St John's wort may cause colic, drowsiness or lethargy in infants, the article says. Vitamin supplements that do not exceed recommended daily allowances and iron supplements are safe. Dr Debra Kennedy, from the Royal Hospital for Women in Sydney, told online medical newsletter 6 Minutes the main problem was that medical labels were misleading. "We need to look at more descriptive medication labels that don't bunch pregnancy and breastfeeding together," she said. A good example is warfarin, which is not great in pregnancy but not a problem in breastfeeding. Yet if you read the product labelling that's not clear. Australian Breastfeeding Association spokeswoman Meredith Laverty said the organisation's counselling line often received calls from breastfeeding mothers worried about whether they could use medicines. The association's counsellors are not medically trained and cannot provide advice. There is, however, a very good resource for women with these questions - the Mothersafe counselling service run by the Royal Women's Hospital. Mothers and medical practitioners who wanted to know if medications were safe could call the services and ask for advice, Ms Laverty said. The US National Institute of Medicine also provides up to date information on medicines and breastfeeding through LactMed (http://toxnet.nlm.nih.gov).