Can I Take Pepto Bismol While Breastfeeding?

Heartburn, diarrhea, and indigestion…ughhh! Having an upset stomach is no fun at all. It can be very difficult to function when your stomach is acting up, and if you are having to take care of a baby on top of that, it can feel nearly impossible.

If you are a breastfeeding parent experiencing tummy trouble, you might be wondering what you can take for some relief. Perhaps Pepto Bismol has always been your go-to medicine of choice, or maybe it is all you have in your medicine cabinet and you are wondering if it’s OK to take, or if you have to trek out to the drugstore for an alternative.

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.

What Is Pepto Bismol?

Pepto Bismol (bismuth subsalicylate) is a widely available, over-the-counter medication used to treat digestive upset. It can be used to relieve symptoms such as upset stomach, nausea, indigestion, and diarrhea. It’s thought to work by decreasing intestinal inflammation and slowing the flow of excess fluids and electrolytes into your bowels.

You can take Pepto Bismol as a swallowable pill, a chewable pill, or in liquid form. You should talk to a healthcare provider before taking Pepto Bismol, as certain ingredients may cause allergic reactions, and people with certain medical conditions may be precluded from taking it.

Importantly, Pepto Bismol should not be taken by anyone with allergies to salicylates or aspirin. It should be avoided by people who have medical conditions like bleeding disorders, liver or kidney disease, or anyone who was recently ill with a viral infection. Pepto Bismol is not safe for kids under the age of 12, and it’s not recommended for people who are pregnant.

How Does Pepto Bismol Affect Breastmillk?

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, and 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,” King notes.

Dr. Kramer agrees that it would be helpful if there was more research available. Because of the lack of research, taking Pepto Bismol while breastfeeding is not something he would recommend, either.

“Not much research has been done on this but we do know that salicylates can cross the placenta and can be found in breast milk,” Dr. Kramer commented. “The baby should not be exposed to too many aspirin-like compounds in breast milk.”

Most of all, says Dr. Kramer, 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.

Reye's syndrome is an illness that usually occurs in children who are under 15 years old. It usually occurs after children have been infected with a virus, and then ingest aspirin or any medication containing aspirin ingredients.

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 include sudden vomiting, followed by symptoms such as extreme fatigue and listlessness. After this, your child may become agitated, confused, and even unresponsive. Later stages of the disease include seizures and the possibility of slipping into a 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 for pregnant individuals either.

Once you are done breastfeeding, you can resume taking Pepto Bismol. But, of course, you should speak to a healthcare provider before taking any medication, especially if you have never taken it before.

Breastfeeding Safe Alternatives

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 to relieve tummy issues.

Alternative Medications

While Pepto Bismol is not recommended while breastfeeding, other medications may be more breastfeeding-friendly and work well to treat symptoms like heartburn, indigestion, or diarrhea.

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.

Dr. Kramer 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

There are several natural remedies that can help with your digestive symptoms and that are safe to consume while breastfeeding. Dr. Kramer recommends peppermint or ginger tea as a way to decrease your indigestion and stomach upset.

Ginger can be very helpful to treat the nausea associated with digestive issues. Besides 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.

A Word From Verywell

Dealing with a bout of indigestion, heartburn, or diarrhea is unpleasant enough, but if you find out that a medication you are hoping to take to treat your symptoms is not advisable, it’s understandable that you might feel frustrated or unsure of what to do.

Although Pepto Bismol is something that should be avoided while you are breastfeeding your little one, there are several effective medications and treatments that are compatible with breastfeeding. So, there is light at the end of the tunnel, and you should be able to feel like yourself again soon.

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 healthcare provider.