Is It Safe to Use Pepto-Bismol During Pregnancy or Breastfeeding?

This is a tricky question without a crystal-clear answer.

Even though Pepto-Bismol is an over-the-counter drug, it’s still important to question its safety. The active ingredient in Pepto-Bismol is bismuth subsalicylate.

According to a 2014 review in American Family Physician, you should avoid taking Pepto-Bismol during the second and third trimesters of your pregnancy. This is because it raises your risk of bleeding problems when you take it closer to delivery.

However, there is controversy over the safety of taking it at any time during pregnancy or while breastfeeding.

If your doctor recommends taking the drug during the first trimester of pregnancy, it’s probably best to use Pepto-Bismol as few times as possible and only after discussing this with your doctor.

Here are a few other things to keep in mind about using Pepto-Bismol during pregnancy:

Lack of research

The active ingredient in Pepto-Bismol is a type of drug called a subsalicylate, which is a bismuth salt of salicylic acid. The risk of problems from salicylates is thought to be small. However, there is no definitive clinical research on subsalicylates in pregnant women.

That’s namely because it’s not ethical to test drugs on pregnant women, as effects on fetuses would be unknown.

Pregnancy category

The Food and Drug Administration (FDA) has not assigned a pregnancy category to Pepto-Bismol. This means that it isn’t known for sure if Pepto-Bismol is safe for use in pregnant women, leading most experts to say it should be avoided.

Birth defects

Research has not proved a connection to birth defects nor has it disproved a connection.

Confused yet? The best thing for you to do is to take all of this information and talk with your doctor about it. Your doctor can tell you more about the risks and benefits of using Pepto-Bismol during pregnancy.

They can also help determine if taking Pepto-Bismol is a good option for you and your pregnancy in particular.

If you and your doctor decide that Pepto-Bismol is safe for the first few months of your pregnancy, follow the package dosage instructions. Be sure to take no more than the recommended dosage, and try to take the smallest amount that you can.

Similar to pregnancy, the safety of Pepto-Bismol during breastfeeding is a bit unclear. It isn’t clinically known if Pepto-Bismol passes into breast milk. However, it is known that other types of salicylates pass into breast milk and may have harmful effects on a breastfeeding child.

The American Academy of Pediatrics suggests using caution with salicylates such as Pepto-Bismol while breastfeeding. And the National Institutes of Health suggests finding an alternative to Pepto-Bismol altogether.

It’s best to talk with your doctor about whether or not Pepto-Bismol is safe for you while breastfeeding.

To be on the safe side, you can always talk with your doctor about other options to treat your digestive problems while pregnant or breastfeeding. Your doctor may suggest other medications or natural remedies. These options may include the following:

For diarrhea

• loperamide (Imodium)

For acid reflux or heartburn

• cimetidine (Tagamet)
• famtidine (Pepcid)
• nizatidine (Axid)
• omeprazole (Prilosec)

For nausea

Your doctor may suggest natural remedies for nausea or upset stomach. These options may include ginger, peppermint tea, or pyridoxine, also known as vitamin B-6. You might also try anti-nausea bands that you wear on your wrists.

Talking with your doctor is always your best option if you have concerns about taking any medication while pregnant or breastfeeding, including Pepto-Bismol. Be sure to ask any questions you have, such as:

• Is it safe to take an over-the-counter medication while I’m pregnant or breastfeeding?
• How long and how often can I take medication?
• What should I do if my digestive symptoms last longer than a few days?

With your doctor’s guidance, you can likely relieve your digestive issues and return to enjoying your pregnancy.