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Pepto-Bismol is a medication popularly used to treat high stomach acidity and abdominal discomfort, even among lactating mothers. But women with breastfeeding infants should be extra careful while taking this drug since it can easily find its way into breast milk.
Read this MomJunction post to know all about taking Pepto-Bismol when breastfeeding and the ideal maternal dosage to minimize any impact the drug has on the breastfeeding infant.
What Is Pepto-Bismol?
Pepto-Bismol is an over-the-counter (OTC), antacid medicine used for relief from minor gastrointestinal ailments such as heartburn, nausea, upset stomach, bloated tummy, indigestion, gas, belching, and diarrhea (1). The medicine is available in liquid, capsule, and chewable tablet form.
What Are The Ingredients Of Pepto-Bismol?
The active ingredient of Pepto-Bismol is a compound called bismuth subsalicylate, which plays a significant role in alleviating symptoms of gastrointestinal problems that the medicine is used for. The concentration of the compound varies as per the form of the medicine. Nevertheless, the manufacturer recommends no more than eight doses of the medicine in 24 hours.
Is It Safe To Have Pepto-Bismol While Breastfeeding?
No. The United States Centers for Disease Control and Prevention recommends that lactating mothers avoid the use of bismuth subsalicylate, as it can find its way into breast milk (2). Although there is limited research on this, use of Pepto-Bismol is not recommended for lactating moms, owing to the potential side effects that bismuth subsalicylate can lead to in babies (3).
What Are The Side Effects Of Pepto-Bismol On Breastfeeding Baby?
The side effects of Pepto-Bismol/Bismuth subsalicylate on the health of the infant are unknown. But there is some research on the impact of the compound salicylate, which is also called salicylic acid. Salicylate is found in Pepto-Bismol as well as in aspirin, whose effects on the breastfeeding baby have been widely researched (4).
Studies suggest that less than 1% of maternal salicylic acid dosage passes into breast milk (5). But the compound still holds the potential to cause the following side effects among breastfeeding infants:
- Reye’s syndrome: Some research suggests that ingestion of salicylic acid by a breastfeeding baby can increase the risk of Reye’s syndrome (6) (7) Reye’s syndrome is an incurable, mostly pediatric condition, which primarily affects the brain and the liver. It causes increased pressure within the brain and the accumulation of fat on the liver (fatty liver) (8). Both the organs lose their ability to function normally.
If not treated promptly, the infant could slip into a coma and eventually become brain dead. Reye’s syndrome due to aspirin has been widely reported, although it is not clear how much salicylic acid in breast milk can induce the problem (9).
It is also not known whether salicylic acid from Aspirin can cause the same side effects as salicylic acid from Pepto-Bismol. Nevertheless, it is best to avoid Pepto-Bismol and reduce the risk for your baby.
- Metabolic acidosis: The American Academy of Pediatrics reports metabolic acidosis as a side effect caused by maternal salicylate dosage (10). Metabolic acidosis is a condition where the pH of the body fluids, including blood, decreases and causes excessive acidity within the body. Acidosis quite commonly occurs due to a problem in the kidneys, which are responsible for maintaining the normal acidity of the body (11).
Considering why you must avoid Pepto-Bismol during lactation, what alternatives do you have to deal with gastrointestinal problems?
What Are The Alternatives To Pepto-Bismol?
There are both medicinal and non-medicinal alternatives to Pepto-Bismol. Options include:
- Loperamide is a compound used for controlling diarrhea, including traveler’s diarrhea (12). A maternal dosage of loperamide is unlikely to affect a breastfeeding baby (13). Just like any other medicine, there are always chances of side effects with Loperamide, especially when overdosed. Therefore, it is best to have it as per the doctor’s prescription only.
- Simethicone provides relief from gas, fullness, and belching. There are no known side effects of the medicine. Some research suggests that not enough simethicone gets absorbed into the body for transfer into breast milk. Also, there is no risk of breastfeeding a baby after a dose of simethicone (14).
- Histamine-based medicines can help cure heartburn. Histamine is a class of compounds, and any one of the many such drugs can be used as a safe replacement for Pepto-Bismol. A few examples of histamine compounds are cimetidine and ranitidine (15) (16).
These medicines do not cause adverse reactions, and ranitidine is even given to infants. Your baby may need to be at least two months old for you to have any histamine-based medicines.
- Proton-pump inhibitors: These are a class of medicines that help regulate the production of acid by the stomach to prevent acidity. Examples include esomeprazole and omeprazole (17) (18). A low, regulated dosage of these medicines is unlikely to cause any side effects in the breastfeeding baby (19).
- Sodium bicarbonate and calcium carbonate-based antacids: You can consider antacids made with sodium bicarbonate (baking soda) to relieve acidity. These compounds have a localized effect within the stomach, and maternal dosage is seldom known to cause side effects in a breastfeeding baby.
- Increased fluid intake, avoiding acidic foods, chewing ginger: You can also employ some safe home remedies such as having electrolytes during diarrhea, avoiding acidic foods, and chewing on a piece of ginger to prevent nausea.
Always consult your doctor before having any medicine during lactation. Avoid taking any OTC medicines The alternative compounds for bismuth subsalicylate come in various brands and with different concentrations.
Pepto-Bismol has several benefits, but when you are lactating, the safety of the baby matters the most. Try natural remedies at first, although in consultation with the doctor. If they don’t help, check for alternatives as recommended by the medical professional.
Did you have to take Pepto-Bismol while breastfeeding? Tell us about your experience in the comment section below.
References:
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