Is Oseltamivir (Tamiflu) safe during breastfeeding?

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Last updated: February 21, 2025View editorial policy

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From the Guidelines

Oseltamivir (Tamiflu) is safe to use during breastfeeding, as only small amounts of the drug pass into breast milk and it's unlikely to cause harm to a nursing infant. According to the American Academy of Pediatrics (AAP) recommendations for prevention and control of influenza in children, 2018-2019 1, breastfeeding should be encouraged even if the mother or infant has influenza, and treatment with oral oseltamivir is preferred if the breastfeeding mother requires antiviral agents. The recommended adult dose is 75 mg twice daily for 5 days for treatment of influenza, or 75 mg once daily for 10 days for prevention. Some key points to consider:

  • The benefits of treating or preventing influenza in the mother typically outweigh any potential risks to the breastfed baby 1.
  • It's essential to consult with a healthcare provider before taking any medication while breastfeeding.
  • Monitoring the baby for any unusual symptoms or side effects is crucial.
  • Breast milk can provide antibodies that may help protect the baby from the flu, so continuing breastfeeding as normal is recommended.
  • Oseltamivir works by inhibiting the influenza virus from spreading in the body, which can reduce the severity and duration of flu symptoms, and starting treatment within 48 hours of symptom onset is most effective 1.

From the FDA Drug Label

Based on limited published data, oseltamivir and oseltamivir carboxylate have been shown to be present in human milk at low levels considered unlikely to lead to toxicity in the breastfed infant. Postmarketing experience has not reported any information to suggest serious adverse effects of oseltamivir exposure via breast milk in infants It is not known if oseltamivir affects human milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for oseltamivir phosphate and any potential adverse effects on the breastfed child from the drug or from the underlying maternal condition.

Oseltamivir (Tamiflu) is considered safe during breastfeeding, as the drug and its active metabolite are present in human milk at low levels, and there have been no reports of serious adverse effects in breastfed infants. However, the decision to use oseltamivir during breastfeeding should be made considering the mother's clinical need and potential risks to the infant 2.

From the Research

Safety of Oseltamivir (Tamiflu) during Breastfeeding

There are no direct studies provided that specifically address the safety of Oseltamivir (Tamiflu) during breastfeeding. However, general guidelines for medication use during breastfeeding can be considered:

  • The amount of medication that enters breast milk varies based on the maternal serum concentration and the pharmacologic properties of the medication 3.
  • Most commonly used drugs are relatively safe for breastfed babies, with the dose received via milk generally being small 4.
  • Certain medications are absolutely contraindicated during breastfeeding, but Oseltamivir (Tamiflu) is not explicitly mentioned in the provided studies 3, 4, 5.

General Principles for Medication Use during Breastfeeding

When considering the use of any medication during breastfeeding, the following factors should be taken into account:

  • Pharmacokinetics of the medication
  • Duration of maternal therapy
  • Age of the infant
  • General health of the infant 6, 7
  • Reliable and updated information on medication safety during breastfeeding should be consulted 6, 3, 7

Resources for Medication Safety during Breastfeeding

Several resources are available to provide information on medication safety during breastfeeding, including:

  • Reference books
  • Online medical literature 6, 7
  • Government-sponsored resources, such as LactMed 3
  • State-based medicines information services 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Medication Safety in Breastfeeding.

American family physician, 2022

Research

Drugs in breastfeeding.

Australian prescriber, 2015

Research

Medication and breastfeeding.

Journal of biological regulators and homeostatic agents, 2012

Research

Drugs and breastfeeding: instructions for use.

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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