Proton-pump-inhibitors for treatment of reflux in a breastfeeding mother: which is preferred?

· Trent Medicines Information Service

There is limited experience with the use of omeprazole and pantoprazole during lactation. Milk levels for both drugs are low, and in addition a large proportion of any of the drug ingested by the infant is likely to be destroyed by the acid in the stomach. No adverse events were reported in one case report of an infant exposed to omeprazole via breast milk. There are no data on long-term outcome.

There are no data available regarding use of lansoprazole, rabeprazole or esomeprazole during breastfeeding.

If a PPI is regarded necessary during lactation, limited data support the use of omeprazole or pantoprazole, and an influence on a breastfed child’s development is unlikely.