No, you should not take Pepto Bismol while breastfeeding. Learn more about why you may want to hold off until you are done breastfeeding.
Medically reviewed by Alyssa Dweck, MS, MD, FACOGMedically reviewed by Alyssa Dweck, MS, MD, FACOG
Stomach aches are the worst and it can be very difficult to function when your stomach is acting up and if you have to take care of a baby. But experts advise to avoid taking Pepto Bismol while breastfeeding. The main concern about taking Pepto Bismol while breastfeeding is that your baby may be exposed to the salicylates in the medication. Salicylates can trigger Reye's syndrome in children under 15.
If it has always been your go-to medicine of choice or is all you have in your medicine cabinet, you may want to think twice and restock with safer options for now. Read on to learn about the risks of Pepto Bismol and alternatives to choose from while you're breastfeeding.
What Is Pepto Bismol?
Pepto Bismol or bismuth subsalicylate, is a widely available, over-the-counter (OTC) medication used to treat digestive upset. It’s thought to work by decreasing intestinal inflammation and slowing the flow of excess fluids and electrolytes into your bowels. It can be used to relieve symptoms including:
Upset stomach
Nausea
Indigestion
Diarrhea
You can take Pepto Bismol as a swallowable pill, a chewable pill, or in liquid form. You should talk to a health care provider before taking Pepto Bismol, as certain ingredients may cause allergic reactions, and people with certain medical conditions shouldn't take it.
Who Shouldn't Take Pepto Bismol
Importantly, Pepto Bismol should not be taken by anyone with allergies to salicylates or aspirin. It should also be avoided by the following people:
Those with bleeding disorders
Those with liver or kidney disease
Anyone who was recently ill with a viral infection
Kids under the age of 12
People who are pregnant
Is It Safe to Take Pepto Bismol While Breastfeeding?
Unfortunately, Pepto Bismol is not considered compatible with breastfeeding, and it’s best to find an alternative way to treat your stomach issues.
As Mitchell S. Kramer, MD, chairman of the department of obstetrics and gynecology at Huntington Hospital explains, Pepto Bismol can pass into breast milk. Although there is not a lot of data on side effects in babies, the main ingredient in Pepto Bismol (bismuth subsalicylate) is not safe for babies to ingest.
“Since Pepto Bismol contains salicylates, aspirin-like compounds, it is safer to use alternatives,” Dr. Kramer advises. Any medication with salicylates in it is considered dangerous for children to digest, as it can trigger Reye’s Syndrome, a very serious illness, particularly in children under the age of 15.
Related: 20 Breastfeeding Tips Every New Parent Should Know
How Does Pepto Bismol Affect Breast Milk?
There is limited data on the safety of Pepto Bismol while breastfeeding. However, because the main ingredient in Pepto Bismol (salicylates) is not safe for babies or children to ingest and is linked to Reye's syndrome, experts do not recommend its use while breastfeeding. Additionally, Lactmed, a government-sponsored website that compiles data on medication safety while breastfeeding, indicates that salicylates could be absorbed by babies via breast milk and recommends looking for alternative treatments.
Rachelle King, RN, IBCLC, a registered nurse and international board-certified lactation consultant, says she doesn’t feel comfortable recommending Pepto Bismol to the breastfeeding parents she works with because of the lack of data, the fact that salicylates are contraindicated in children, and linked to Reye's syndrome.
"More research would be beneficial; however studies involving infants can have serious ethical implications"
Rachelle King, RN, IBCLC
“More research would be beneficial; however studies involving infants can have serious ethical implications,” King notes. Dr. Kramer agrees, and because there are alternative medications that work well to decrease digestive upset and do not contain salicylates, it’s best to try one of those before using Pepto Bismol.
“There are no benefits to taking Pepto Bismol other than helping with the symptoms such as stomach upset and diarrhea,” Dr. Kramer explains. “There are adequate substitutes.”
Risks of Pepto Bismol While Breastfeeding
The main concern about taking Pepto Bismol while breastfeeding is that your baby may be exposed to the salicylates in the medication. Salicylates are an ingredient in aspirin and have been linked to Reye's syndrome, an illness that can have very serious symptoms in children.
Though rare, Reye's syndrome is very serious. It can have an impact on all of a child’s organs, most notably their brain and liver. Symptoms of Reye's syndrome include:
Extreme fatigue and listlessness
Agitation
Confusion
Unresponsiveness
Seizures
Coma
Because Reye's syndrome is so serious, doctors are very risk-averse when it comes to allowing children to ingest any product containing aspirin or aspirin ingredients. This is why Pepto Bismol is not considered a safe choice during pregnancy or while breastfeeding.
When Can I Resume Using Pepto Bismol?
Because of the unknown side effects in infants and the lack of data available, it’s best to refrain from taking Pepto Bismol until you are done breastfeeding. You should also be sure that you are not pregnant at this time or expect to become pregnant in the near future, as Pepto Bismol is not recommended during pregnancy either.
Once you are done breastfeeding, you can resume taking Pepto Bismol, but you should speak to a health care provider before taking any medication, especially if you have never taken it before.
Alternatives to Pepto Bismol
It can be disappointing to learn that a medication you want to take is off-limits while you are breastfeeding, especially when you are looking for relief from very uncomfortable symptoms. Thankfully, there are many effective alternatives to taking Pepto Bismol while breastfeeding for tummy issues.
Alternative medications
For upset stomach, heartburn, and indigestion, Dr. Kramer recommends antacids like TUMS or Maalox. According to LactMed, antacids are generally safe to take while breastfeeding, and are unlikely to pose any risks to breastfeeding babies.
The doctor also recommends Loperamide (Imodium) to treat diarrhea in breastfeeding parents. Similar to antacids, LactMed describes loperamide as not likely to have a negative effect on a breastfeeding baby.
Natural remedies
Several natural remedies can help with digestive symptoms and are safe to consume while breastfeeding. Dr. Kramer recommends peppermint or ginger tea to decrease indigestion and stomach upset.
Ginger can be very helpful in treating nausea associated with digestive issues. In addition to drinking ginger in tea form, you can consume bits of raw or cooked ginger or try some ginger chews.
Dietary changes
Often, making tweaks to your diet can help relieve digestive issues. “Many of my patients strive to avoid the use of medications at all, and prefer to use whole foods to treat health issues,” says King. “A diet including soft fruits, low fiber starches, and broth can be a safe way to manage diarrhea naturally.”
Dr. Kramer recommends adopting the BRAT diet while managing symptoms like diarrhea. BRAT stands for Bananas, Rice, Applesauce, and Toast. These foods are thought to be “binding” and can help slow the course of diarrhea, allowing you to recover sooner.
As always, if you have any questions about taking medication while breastfeeding or need more information about managing your digestive symptoms, you shouldn’t hesitate to reach out to a health care provider.
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