Is it safe to use creatine (a dietary supplement) while breastfeeding?

Safety of Creatine Supplementation During Breastfeeding

There is insufficient evidence to recommend creatine supplementation during breastfeeding, and it should be avoided due to lack of safety data in lactating women.

Current Evidence on Creatine and Breastfeeding

The available guidelines and research do not specifically address creatine supplementation during breastfeeding. This represents a significant gap in our knowledge about its safety for both mother and infant.

What We Know About Supplements During Breastfeeding

• Most medications that breastfeeding women take are compatible with breastfeeding, but there are limited data on many dietary supplements 1
• The American Academy of Pediatrics recommends consulting reliable resources like LactMed (National Library of Medicine database) for medication safety during breastfeeding 1
• For any substance without specific safety data during breastfeeding, caution is warranted

Creatine Supplementation in General

Creatine monohydrate is a dietary supplement that:

• Increases muscle performance in short-duration, high-intensity resistance exercises 2
• Is generally considered safe in healthy adults when used at recommended dosages (3-5 g/day) 3, 4
• Has been studied extensively in non-breastfeeding populations 4

Why Caution is Warranted

1. No specific safety data in breastfeeding women

   • None of the guidelines or research evidence provided addresses creatine use during lactation
   • The transfer of creatine into breast milk and its effects on the infant are unknown

2. General principles for medication use during breastfeeding

   • The Association of Anaesthetists guideline states: "There are a limited number of agents that are contraindicated, and an appropriate substitute usually can be found" 1
   • Without safety data, unnecessary supplements should be avoided

3. Potential concerns

   • While creatine is generally well-tolerated, common side effects include water retention 2
   • At higher doses or with prolonged use, there have been cases of liver and renal complications 2

Guidance for Breastfeeding Women

For breastfeeding women considering creatine supplementation:

• Prioritize obtaining nutrients through diet rather than supplements when possible
• Consult healthcare providers before starting any supplement during breastfeeding
• Check reliable resources like LactMed, InfantRisk, or MotherToBaby for updated information 1
• Consider waiting until after the breastfeeding period to resume creatine supplementation

Alternative Approaches

Instead of creatine supplementation while breastfeeding, consider:

• Focus on adequate nutrition through a balanced diet as recommended for lactating women 1
• Ensure proper hydration (approximately 700 mL/day higher than non-lactating women) 1
• If exercise performance is a concern, work with a healthcare provider to develop safe training approaches during the breastfeeding period

Conclusion

Until specific research demonstrates the safety of creatine supplementation during breastfeeding, the most prudent approach is to avoid its use. The potential risks to the infant outweigh the potential benefits to the mother, especially when considering that creatine supplementation is primarily performance-enhancing rather than essential for health.