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Drug Info Maternal Matters

Is gabapentin breastfeeding safe?

It’s generally considered safe, with a few exceptions
Carry Murphy headshot
By | Jan. 10, 2025 Medically reviewed by Laura K. Grubb, MD, MPH
A bottle and a pill | gabapentin breastfeeding

Key takeaways

  • The use of gabapentin is generally considered safe for both breastfeeding parents and their infants.

  • For both parents and babies, the main risk of gabapentin while breastfeeding is sedation. This is a greater risk for premature or medically fragile infants.

  • Speak to your healthcare provider to make sure gabapentin is the right medication for you as a nursing parent.

  • Check with your healthcare provider about breastfeeding and gabapentin if you are taking other prescription medications, over-the-counter medications, supplements, or are using alcohol.

In this article:

Gabapentin is a prescription medication used to treat nerve pain and epilepsy. Although gabapentin is an anticonvulsant, it’s often used off-label to treat restless legs syndrome (RLS) and other nerve conditions or neuropathic pain. It can also treat postherpetic neuralgia, a type of pain that happens after having shingles. Brand names include Neurontin and Gralise. If you’re breastfeeding, you should know that gabapentin is generally safe for both breastfeeding parents and their infants.

Can you take gabapentin while breastfeeding?

Typically, a breastfeeding mother would be prescribed gabapentin for restless legs syndrome or another neuropathy (nerve pain) condition, explains Rebecca Berens, MD, IBCLC, a family practice physician and lactation consultant in Houston, Texas: “Restless leg syndrome, often related to iron deficiency, is common in pregnancy and postpartum. For example, if someone experienced significant blood loss during delivery, they could develop restless leg syndrome while waiting for iron levels to normalize. Chronic neuropathies, such as those linked to diabetes or past injuries, could also require ongoing gabapentin use.”

There is mixed data about gabapentin use and safety during pregnancy. Studies suggest that it may be safe in the first trimester, but toxicity increases throughout the pregnancy. However, the consensus among researchers and medical professionals seems to be that the use of gabapentin is safe while breastfeeding. This is because very little of the medication crosses into breast milk and because it does not have any effect on milk supply.

There is some available research on gabapentin and breastfeeding. A 2006 case report in the Journal of Human Lactation concluded that the infant dose of gabapentin was about 2.3% of the maternal dose. Another study in the journal Epilepsia found that gabapentin does transfer into breastmilk, but infant serum concentration was low, and no adverse effects on babies were observed. An expert consensus guideline issued in 2015 affirmed that gabapentin is an acceptable medication to treat restless legs syndrome during lactation.

Dr. Berens emphasizes that there’s little concern with taking gabapentin while breastfeeding. “From available studies, the infant’s serum concentration via breast milk is very low,” she says. “For a healthy, full-term infant, especially after three months, my concerns would be minimal. For medically fragile, preterm, [or low birth weight infants], I’d feel less confident.”

Johanna Macaulay, RN, IBCLC, a neonatal intensive care unit (NICU) lactation consultant at UPMC Harrisburg Hospital in Harrisburg, Pennsylvania, emphasizes getting personalized counseling regarding taking gabapentin if you are breastfeeding or pumping breastmilk for a premature baby: “In the case of a preterm or medically fragile infant, I would recommend to speak to the neonatologist or other specialists about any risks that gabapentin exposure could have. In most infants, even preemies, gabapentin would still be considered safe, but every situation is different. If the infant has certain neurological conditions, they may be more affected by exposure, or if they are on other sedating medications, their sedation could increase.” This may be of greater concern if your baby has also been exposed to opioids in utero or the NICU.

An alternative medication that may be prescribed is pregabalin. Information on pregabalin and breastfeeding is also limited, but it also appears that it is safe and does not have adverse effects on infants.

How long should I wait to breastfeed after taking gabapentin?

Gabapentin is generally taken about every eight hours. The half-life of the drug in adults is about five to seven hours, meaning it takes about that amount of time for the body to clear about half of the dose.

There is currently no recommended time to wait to breastfeed after taking gabapentin. It is unknown how long gabapentin can be detected in breast milk because there is limited data.

There is no need to wait or pump and dump breastmilk if you are taking gabapentin. This is because gabapentin in breast milk is thought to have very little, if any, effects on breastfed infants.

Side effects of gabapentin while breastfeeding

General side effects of gabapentin include dizziness, sleepiness, swelling, headache, weakness in your extremities, diarrhea, and weight gain. More serious side effects can consist of thoughts of self-harm, muscle damage, slow breathing, withdrawal, and severe allergic reactions.

If you’ve taken gabapentin before and know that you experienced some of these side effects, discuss this with your healthcare provider. It may not be appropriate for you to take gabapentin again.

If you’re breastfeeding, the most important side effect to watch out for when taking gabapentin is sedation. “Gabapentin can cause sedation, and if a parent feels significantly impaired, it might impact their ability to care for the baby—for example, waking up at night or safely handling the infant,” Dr. Berens explains. “I’d recommend testing taking the medication when another adult is present to observe how you respond. If you feel loopy, unsteady, or overly sedated, I’d suggest discontinuing and consulting your healthcare provider. Still,  the vast majority of people don’t have significant sedation or side effects with it. They do really well, and it helps.”

Although it’s unlikely that the amount of gabapentin excreted into breastmilk could affect your baby, it’s also important to watch your baby for signs of sedation, especially for the first few days of taking gabapentin and if they were born prematurely or have other medical concerns.

How to take gabapentin while breastfeeding

Gabapentin use during breastfeeding should be prescribed on a case-by-case basis. If you’ve been prescribed gabapentin, you should take it as the directions state, including at the appropriate dosage and times of day. There is currently no recommended time to wait to breastfeed after taking gabapentin. It is important to discuss the safety of gabapentin use with your health care provider if you are taking other prescription medications, over-the-counter medications, or supplements. Also, it is best to avoid using alcohol while taking gabapentin. 

If you’re breastfeeding and taking gabapentin for the first time, it is key to monitor yourself closely for side effects, especially drowsiness and sedation.

Keep in close contact with your healthcare provider to let them know how you’re feeling. Dr. Berens advises, “Follow up with the physician after a couple of weeks to assess tolerance and effectiveness.”

The bottom line

It is generally safe to take gabapentin while breastfeeding. If you are prescribed gabapentin, be sure to tell your medical provider that you are breastfeeding and make a plan with them to monitor yourself and your baby for any adverse effects. Dr. Berens stresses, “Side effects like sedation are uncommon, but they’re worth monitoring. For healthy infants, the risk from breast milk exposure is minimal.”

Macaulay adds that many healthcare professionals will warn against breastfeeding while taking a new medication without “much knowledge of if and how a medication passes into breastmilk.” If parents are concerned about their medication options while breastfeeding,  they can also contact an International Board Certified Lactation Consultant (IBCLC) for more information or look at the National Library of Medicine LactMed database to help them make an informed choice.