Has anyone purchased brstmilk?

[BakersDozen]

I am unable to keep up with my babies' demand for milk and dread using formula with them. A local lady has over 800oz in her freezer and has asked me to make an offer (she is currently charging 1.50/ounce). I have no idea what to offer her! Has anyone purchased milk privately? I know the milk bank charges at least $3.50/ounce so $1.50 is a great price yet we cannot afford to pay that much. It's hard when I know I can get formula for about .15/ounce. Why is it that the healthy stuff is the most expensive??

 

Any thoughts/suggestions?

[ravinlunachick]

Unless I knew the donor personally, and felt secure that there would be no drugs or viruses present in the milk, there's no way I'd buy it from an individual. This is coming from someone who nursed all 3 kids exclusively (and is still in the process of weaning the last!). I'd rather give formula than risk giving my infant a potentially deadly disease.

 

However, if I were certain as to the safety, I'd probably buy enough as my budget allowed, but I'd most likely try to stretch it out as much as I could, even if that meant doing the occasional bottle of formula for an older child. I don't think formula is evil or anything. Obviously, human milk is preferable nutritionally, but you shouldn't beat yourself up for using it.

 

Have you determined the reason for the lack of supply? Maybe a LLL leader or IBCLC could help figure out a way to at least improve your supply so you're using less supplementation.

[jennsmile]

No but I have donated milk to a friend.

www.milkshare.com might be a good place to look for options. You pay only for shipping and handling not for the milk. :grouphug:

[AimeeM]

I assume the woman has been screened for any medications or diseases that could transfer to breastmilk?

I believe that is why banks charge so much - the milk is sent through a screening process (from what I understand; I could be wrong).

 

If she has been screened, maybe you could ask her if she'd be willing to take $800 if you bought the bulk load?

[ReneTL]

I've never purchased breast milk, but I would be a bit uneasy with purchasing privately unless I knew the person VERY well, but that's just me. I would probably find a good lactation consultant. Hang in there!

 

Peace,

Rene

[jennsmile]

I know you didn't ask but here are tips for increasing your supply.

 

http://kellymom.com/bf/supply/low-supply.html

 

Twins can be hard, but you can do it. It does take time though and with a household full it might be a challenge. I think it is awesome you are trying to give them only breastmilk. :grouphug::grouphug:

[Impish]

Due to health issues, I'm unable to nurse Boo.

 

No way in Hades would I buy breast milk.

 

Here, there isn't the same banks available, so no testing, etc.

 

At least I know formula doesn't have any communicable illnesses, meds, alcohol or drugs in it.

[ThelmaLou]

I highly recommend asking your doctor to prescribe domperidone for low milk supply (in addition to taking all the other usuals, like fenugreek). It was only when I took domperidone after my 5th baby that I finally had abundant milk. I struggled with the first four babies, and my mom is a lactation consultant who gave me all the tricks in the book. Domperidone is absolutely amazing. I don't know whether it still has to be obtained at a compounding pharmacy or not, you'll have to check. Here's a link about it by Dr. Jack Newman who's amazing on all things breastfeeding related:

http://www.breastfeedinginc.ca/content.php?pagename=doc-DGS

[jennsmile]

Due to health issues, I'm unable to nurse Boo.

 

No way in Hades would I buy breast milk.

 

Here, there isn't the same banks available, so no testing, etc.

 

At least I know formula doesn't have any communicable illnesses, meds, alcohol or drugs in it.

 

Imp I understand you can't nurse. :grouphug:

[beaners]

I know that there are very few diseases that can be transmitted via that particular fluid, but I probably wouldn't be comfortable with that arrangement unless it was a family member or very close friend.

 

Personally, I'd probably nurse both babies as much as possible, and supplement with formula for the rest. I believe most of the health benefits of nursing are provided as long as each baby is getting an ounce or so a day. I think I read that at one point?

[WishboneDawn]

I'd be hesitant to buy breast milk as well.

 

Formula isn't breast milk but it IS good food. Just food but still, food. I've been a rabid anti-formula person in the past but when I was in the hospital with Lauchie and he was nursing constantly and I was in desperate need of some sleep after a pretty physically-traumatic birth...well, I made my peace with formula. It's not poison, it's safe, it's nutritious, it IS healthy (just not as healthy as breast milk) and it gave me a few hours of rest that I desperately needed at that point.

 

Unless I could get milk from a milk bank with strict procedures or had a good friend I could trust I would not accept breast milk from another woman.

[HiddenJewel]

Have you researched the option of goat's milk?

[TranquilMind]

I am unable to keep up with my babies' demand for milk and dread using formula with them. A local lady has over 800oz in her freezer and has asked me to make an offer (she is currently charging 1.50/ounce). I have no idea what to offer her! Has anyone purchased milk privately? I know the milk bank charges at least $3.50/ounce so $1.50 is a great price yet we cannot afford to pay that much. It's hard when I know I can get formula for about .15/ounce. Why is it that the healthy stuff is the most expensive??

 

Any thoughts/suggestions?

Seems really mercenary to charge for breast milk. $1.50 an OUNCE?

 

Wow. Well, what goes around comes around. Someday if she needs water for her family in an emergency someone will sell it to her for $1.50 an ounce.

 

I never had enough either, but if I were overly blessed with milk, I'd give it away to people who felt comfortable that I am healthy, which I am.

 

My midwife once fed my daughter, because she was starving! I had to start supplementing with formula. No, the lactation consultant didn't help a bit when 7 hour sessions with bleeding nipples were the norm.

[TheAutumnOak]

I wouldn't do it...

I have three boys...I nursed my first for a short time then gave him formula...My last two I nursed exclusively...They went from nursing to drinking from a cup...They have never had a bottle, and I didn't even pump my own milk...

I say all of this to say that obviously I see the benefit of nursing...But if I had another child and couldn't nurse or keep up with the demand for whatever reason, I would feel fine about giving my child formula...My first son turned out fine...I would suggest nursing part time and giving formula part time...I would only give another mother's milk if it was family or I knew the person well and they were giving it to me...I would never purchase it...

[AimeeM]

Eh. I kind of understand charging for it. Nursing your own child, with your abundant milk supply is easy for some of us; but PUMPING and the work that goes into properly freezing the breastmilk, as well as the supplies? Well, I think she has a right to charge. I've never pumped but have always had a great supply with my now 2 1/2 year old son. It would take time, effort, pain, AND money (invested; into a pump and other supplies) to get me to pump for someone else. And you can't really compare needing water to needing breastmilk. There are, after all, other options to feed your infant. While breast is best, formula is a fine alternative.

On that note, breastmilk is a bodily fluid and I would never use another woman's supply unless we were stuck in a situation where it sincerely WAS my only option. I still occasionally nurse my 2 1/2 year old, he has only been nursed (no bottles); but I have every intention of using formula with the next. Lol.

Seems really mercenary to charge for breast milk. $1.50 an OUNCE?

 

Wow. Well, what goes around comes around. Someday if she needs water for her family in an emergency someone will sell it to her for $1.50 an ounce.

 

I never had enough either, but if I were overly blessed with milk, I'd give it away to people who felt comfortable that I am healthy, which I am.

 

My midwife once fed my daughter, because she was starving! I had to start supplementing with formula. No, the lactation consultant didn't help a bit when 7 hour sessions with bleeding nipples were the norm.

Edited January 6, 2012 by AimeeM

[justasque]

I would absolutely not purchase breastmilk from anyone but a milk bank. You are trusting not only your donor, but her sexual partner. And a one-time test isn't good enough; infection could occur any time. There is a reason there are milk banks. No way would I put my baby at risk.

 

Your choices are:

1) Increase your supply. I'm assuming you're nursing on demand, getting plenty of skin-to-skin contact, and consulting a professional (or LLL Leader) who can help you develop other strategies.

 

2) Supplement with banked human milk.

 

3) Supplement with breast milk substitutes (formula, etc.)

 

It's just like the "would you eat this" threads here. Sometimes, the financial savings isn't worth the risk. This, IMHO, is one of those times.

[Mom-ninja.]

I would not do it. I'm a LLL leader so I'm obviously a huge advocate for breastfeeding. However, the health risks to your baby are too many.

 

Selling breast milk? Geesh. I question her ethics.

[In the Rain]

I would absolutely not purchase breastmilk from anyone but a milk bank. You are trusting not only your donor, but her sexual partner. And a one-time test isn't good enough; infection could occur any time. There is a reason there are milk banks. No way would I put my baby at risk.

 

 

 

:iagree:

[LMK]

Sorry, I have to agree with all the naysayers. As a mom who has breastfed all 5 of my girls, I understand wanting to feed breastmilk. As a nurse, the risk factor of buying someone else's breastmilk that has not been screened is just too great. If you break it down you are relying a lot on this one person to: not drink, not do drugs, have any communicable diseases, properly store the milk, properly clean the pump etc. Also, my big question would be: Why isn't SHE using it for HER child? And then there is: How old is the milk? Frozen milk can last a very long time. But, has it ever been defrosted? Has her house ever lost power and thus the milk has defrosted and refrozen? Again, why is she selling milk that she could be mixing in baby food? If her child is too old for the breastmilk, then that milk is probably too old for others to use as well. Formula is a safer alternative if you are unable to increase your supply via the methods that others have mentioned.

 

Just had to add my thoughts.

 

LMK

[jennsmile]

I can't find the list but I remember reading a while ago a list of what to feed to infants. It went something like this, if you can find the list let me know.

 

I want to say it was from a WHO publication

 

1. Mom breast feeds

2. Wet nurse

3. Donor milk bank

4. Formula

 

While some of us might not think to feed only breastmilk, I would rather feed breastmilk before formula if I had the chance. I have read of a woman with only a bOOK who fed twins, I have read of another who couldn't nurse and was able to get enough breastmilk for her son for the first year of his life or longer. DH knows if anything every happens my infants are to get breastmilk.

 

Most of us are blessed to live in countries where we have access to fresh water, heat and are literate. Not to mention having the $ to purchase formula. In other countries a child on formula has a much higher risk of illness and death because they don't have fresh water or the means to purchase the formula so it is watered down.

 

I realize not everybody feels the way I do and I don't mean to offend. If you have chosen to formula feed of have medical reasons why you can't I understand and I am not judging you.

 

To the OP I am pm'ing you.

[NicAnn]

Don't pay for it! Most women will gladly donate. Check out milkshare and Eats on Feets. Contact the local LLL or Attachment Parenting group. Many people will ship free if you are in a small area.

[WishboneDawn]

I can't find the list but I remember reading a while ago a list of what to feed to infants. It went something like this, if you can find the list let me know.

 

I want to say it was from a WHO publication

 

1. Mom breast feeds

2. Wet nurse

3. Donor milk bank

4. Formula

 

While some of us might not think to feed only breastmilk, I would rather feed breastmilk before formula if I had the chance. I have read of a woman with only a bOOK who fed twins, I have read of another who couldn't nurse and was able to get enough breastmilk for her son for the first year of his life or longer. DH knows if anything every happens my infants are to get breastmilk.

 

Most of us are blessed to live in countries where we have access to fresh water, heat and are literate. Not to mention having the $ to purchase formula. In other countries a child on formula has a much higher risk of illness and death because they don't have fresh water or the means to purchase the formula so it is watered down.

 

I realize not everybody feels the way I do and I don't mean to offend. If you have chosen to formula feed of have medical reasons why you can't I understand and I am not judging you.

 

To the OP I am pm'ing you.

 

This is stuff I know and I'm sure most women here know and it's preferable if someone can increase their milk supply or find a safe supply of breast milk certainly but if those two conditions can't be met, formula is a good alternative.

 

I'm with you. I'm an extended breast feeder whose kids have had perhaps a few ounces of formula between them all and only one has ever had a bottle for any reason but because formula is at the bottom of the WHO list doesn't mean it's a bad substitute and can't produce a healthy baby and if the choice is between unscreened and expensive breastmilk and formula then I think formula is a clear winner.

 

Like everyone else I think increasing supply is the best answer but I also think formula is the best second option in this case.

[HiddenJewel]

I did not have enough milk with my first and had to use formula. She has had the worst immune system of all my dc. If it occurs again I will definitely be looking for another alternative.

[AimeeM]

I did not have enough milk with my first and had to use formula. She has had the worst immune system of all my dc. If it occurs again I will definitely be looking for another alternative.

Lol - it's funny how experiences can differ so much.

My daughter (now 10) was formula fed and is much, much healthier than my breastfed 2 1/2 year old (exclusively breastfed until after a year old; still nurses at night).

[MistyMountain]

http://www.hm4hb.net/

 

http://www.eatsonfeets.org/

 

Those are milk share organizations where I don't believe they charge.

[Mergath]

Lol - it's funny how experiences can differ so much.

My daughter (now 10) was formula fed and is much, much healthier than my breastfed 2 1/2 year old (exclusively breastfed until after a year old; still nurses at night).

 

:iagree: Dd only had breastmilk for a few weeks and then had to switch to formula because the meds I was on weren't safe while breastfeeding. I can count on one hand all the times in her life she's been sick, and she's quite smart to boot.

 

OP, I agree with the pps who wouldn't risk it. Breastmilk is only better if you know it's safe. If you can't be sure, it's better to go with formula. The formulas they have today might not be quite as good as breastmilk, but they're pretty darn close.

[LaxMom]

Count in another exclusive, extended breast feeder who would be leery of acquiring milk privately. I would go through and organization, or I would supplement with formula via SNS while doing what I could to increase supply.

 

Situations where mom is unable to nurse or produce enough is the reason for infant formula, IMO.

[happypamama]

Again, why is she selling milk that she could be mixing in baby food?

 

Maybe she doesn't do baby food. I don't; I don't start solids until close to a year, and we go right to table foods, no cereal or purees needed, so no breastmilk needed to mix with the baby food. Maybe this woman knows that other women could use the breastmilk, so she's been pumping and storing for a while and is asking for some money in compensation for her time and materials.

 

To the OP, I would probably try to go through milkshare or somewhere similar, though I'd probably try to see if I could find a friend to get milk from first. I'd want to see evidence of screening and such first too.

 

ETA: If I needed to supplement and could not get safe breastmilk, I would consider making my own formula from raw milk and vitamins (there are recipes available about how to do this).

Edited January 6, 2012 by happypamama

[Farrar]

I'm a huge breastfeeding advocate, but I wouldn't. Someone I knew of made her own supplements for her dd from a really young age - just a few months old. I would rather do something like that than buy untested breastmilk.

 

Hugs! Infant twins are tough and breastfeeding twins is really tough. I've been there!

[smilesonly]

i haven't read the responses, but the first thing i thought of was why the h-e- double hockey sticks doesn't she just give it to you?

 

man, some people.:rolleyes::mad:

 

off to read the replies.:grouphug::grouphug:

[smilesonly]

Maybe this woman knows that other women could use the breastmilk, so she's been pumping and storing for a while and is asking for some money in compensation for her time and materials.

 

 

wow, that would be some SAHM business.:lol:

[Hannah C.]

The Leaky B@@b might have info that you would find helpful. It's a Facebook page and a website, with lots of info and resources.

[MrsJewelsRae]

I would and have used breast milk from another mother to feed my oldest, but I would have to know the woman pretty well in order to feel comfortable without testing. In my case, it was my best friend's frozen stash that she gave me to help feed my ds when I was sick with a really wicked flu. I also urge you to ask your doctor for Domperidone, that stuff was amazing! I woke up 2 days later fully engorged and the wonderful sound of my baby actually guzzling snd chugging milk until satisfied. I hope you can find something that works for you. Definitely check out Dr Jack Newmans site.

[jennsmile]

i haven't read the responses, but the first thing i thought of was why the h-e- double hockey sticks doesn't she just give it to you?

 

man, some people.:rolleyes::mad:

 

off to read the replies.:grouphug::grouphug:

 

I know when I pumped for a friend she provided the pump and the storage bags. I do agree she should donate and not sell but should be paid for supplies and possibly storage.

[MrsJewelsRae]

Forgot, have you looked into goats milk? Check on Dr Sears site, I remember reading about his goat milk formula a few years back, it might be worth looking into.

[amey311]

I would and have used breast milk from another mother to feed my oldest, but I would have to know the woman pretty well in order to feel comfortable without testing. In my case, it was my best friend's frozen stash that she gave me to help feed my ds when I was sick with a really wicked flu. I also urge you to ask your doctor for Domperidone, that stuff was amazing! I woke up 2 days later fully engorged and the wonderful sound of my baby actually guzzling snd chugging milk until satisfied. I hope you can find something that works for you. Definitely check out Dr Jack Newmans site.

 

FYI: in the US it's getting harder to get doctors to write prescriptions for Domperidone for breastfeeding. The FDA has issued warnings about it and in some cases have confiscated it if it was purchased from outside the US.

 

 

I'm not saying I agree with them, I'm just sharing the information. I know Jack Newman thinks the restriction is illogical.

[BakersDozen]

but the first thing i thought of was why the h-e- double hockey sticks doesn't she just give it to you?

 

I kept hoping she would offer to do that but nothing came of it. Oh well.

 

The woman is a first-time 30yo mom whom I know so I do feel comfortable using milk from her. I have used formula with my other babies (limit of one bottle/day if that) and had no ill effects. With these babies, however, I notice an immediate affect on their digestive system/bowel movements. Maybe it's because they were premature that I am more concerned this time around. Or maybe I noticed that "corn syrup solids" is one of the main ingredients in formula (why did I never notice that before??).

 

I have been on supplements like you wouldn't believe, am drinking enough to drown myself, have not lost a bit of weight as I am eating what I need to in order to keep up what supply I have, and am even limiting my exercise regiment. I've posted on Eats on Feets with no luck and have had my midwife put out the word that I am looking for milk. Again, no luck.

 

I do understand the hesitancy in accepting milk from strangers and appreciate the concerns expressed by all here. For now I'll keep nursing/pumping around the clock and keep them on as much brmilk as possible for as long as possible.

Edited January 7, 2012 by LuvnMySvn

[happypamama]

I'm sorry you are having supply issues. A couple of things to consider (assuming the babies actually are not gaining well). One, have you had your thyroid checked by a specialist? They may tell you it's "fine," when it's in the 4ish range, but many women with symptoms (and low milk supply can be one) find that they do better when their TSH levels are more in the 2ish range. And two, have the babies been evaluated by a really good certified lactation consult? The LC should look for any of the various types of tongue and lip tie. Do either of the babies "click" while nursing? (Not the suck-swallow-breathe click; it's a click that means the baby is losing suction.) If so, have them evaluated immediately for bubble palate. Those things can all cause inefficient milk transfer, which can mean that the baby can't nurse effectively enough to empty the breast very well, so your body doesn't get the message to make more milk.

[HiddenJewel]

I'm sorry you are having supply issues. A couple of things to consider (assuming the babies actually are not gaining well). One, have you had your thyroid checked by a specialist? They may tell you it's "fine," when it's in the 4ish range, but many women with symptoms (and low milk supply can be one) find that they do better when their TSH levels are more in the 2ish range.

 

The desired TSH levels that I have been told are between 0 and 1 with good Free T3 and Free T4 levels. So even a TSH of 2 may be a problem. 4 is definitely on the old scale of okay.

[hmschooling]

The desired TSH levels that I have been told are between 0 and 1 with good Free T3 and Free T4 levels. So even a TSH of 2 may be a problem. 4 is definitely on the old scale of okay.

 

That's not accurate numbers. A TSH of 0 is huge sign of hyperthyroidism. T3 and T4 can still be normal or high. .5 is the bottom acceptable number for TSH and most do better with it higher than that. The new high of the range is 3.5 I think (it was 5 is I'm remembering correctly) but many doctors will allow higher before considering hypothyroidism. I have a hefty case of autoimmune hyperthyroidism with TSH level of .02 and t3/t4... one was high and one was normal. .02 was low enough I was hospitalized for heart problems and all sorts of issues including hair loss, insomnia, etc b/c it allows my thyroid levels to get too high and mess me up.

 

 

Kep in mind that breastmilk is produced with the age/needs of the babies in mind, so you'l want to get milk that was pumped when her baby was about the same age as yours. Newborn babies have different needs than a 4month old, for example, when it comes to fats, sugars, proteins, etc and the levels and ratios within the milk change with the age of the baby.

Edited January 7, 2012 by hmschooling

[staceyobu]

I'd look into domperidone...

[Mergath]

I'd look into domperidone...

 

Is that safe? From the FDA link posted, it looks like it gets into the breastmilk, and they think it might not be safe for babies... :confused:

[HiddenJewel]

That's not accurate numbers. A TSH of 0 is huge sign of hyperthyroidism. T3 and T4 can still be normal or high. .5 is the bottom acceptable number for TSH and most do better with it higher than that. The new high of the range is 3.5 I think (it was 5 is I'm remembering correctly) but many doctors will allow higher before considering hypothyroidism. I have a hefty case of autoimmune hyperthyroidism with TSH level of .02 and t3/t4... one was high and one was normal. .02 was low enough I was hospitalized for heart problems and all sorts of issues including hair loss, insomnia, etc b/c it allows my thyroid levels to get too high and mess me up.

 

 

 

 

There are so many different theories on thyroid out there that each person has to determine what is his/her optimal level and go with that. A low TSH and regular T3 and T4 is not always hyper (and I've had hyper so I know what that is like). TSH 0.5 is about right for me as long as my T3/T4 is good. I don't have the antibody component so that may add another dimension I no longer have to deal with.

[cindergretta]

Is that safe? From the FDA link posted, it looks like it gets into the breastmilk, and they think it might not be safe for babies... :confused:

 

It's actually given to babies in hospital via IV for gastro issues at *much* higher doses than anythings secreted into breast milk. The FDA issues are much more politically/financially based than safety based. Dpd is used around the world as a go-to gastro drug EXCEPT in the US. :glare:

 

In terms of buying the milk, that just squicks me out. :( Not the using the milk, but the idea of a mama selling to another. I have never heard of such a thing. My sister was thrilled to donate her leftover and excess milk to another mama who had a preemie and wasn't making enough. I had offers from mamas to give me their extra milk as I have supply issues. I have just never heard of buying/selling milk. Milk banks aren't charging for the milk for profit, they are charging for ensuring safety, distribution, storage, etc. And mothers that donate aren't given anything for time or supplies. It truly is an act/gift of love.

 

OP, I am sorry you are in this situation. BTDT and it is a daily trial. :( :grouphug: My last two babies couldn't nurse (for a variety of reasons, shocking to a mama who had nursed 4 previous babies extensively) and I pumped 13 months and 12 months respectively for them.

 

Best luck and wishes to you!! :grouphug:

Edited January 7, 2012 by cindergretta

[beaners]

 

I have been on supplements like you wouldn't believe, am drinking enough to drown myself, have not lost a bit of weight as I am eating what I need to in order to keep up what supply I have, and am even limiting my exercise regiment. I've posted on Eats on Feets with no luck and have had my midwife put out the word that I am looking for milk. Again, no luck.

 

Are you drinking too much water? I know I had the best results when I drank to just past thirst. I'm sure you know that and you're just illustrating to us that you are doing everything in your power. (And I was there with my first, so I know how draining and frustrating it can be.) I'm throwing the idea out there just in case.

[TravelingChris]

Formula is a fine alternative. There is no way I would use another person's milk. Just way too risky.

[justasque]

Formula is a fine alternative. There is no way I would use another person's milk. Just way too risky.

 

Just to be clear, human milk is better if it's from the milk bank. Have you thought about asking them if they have any sliding-scale type programs?

Edited January 7, 2012 by askPauline

[Pretty in Pink]

I am unable to produce any breastmilk. The only way that I would purchase breastmilk would be through a milk bank but, since that is cost prohibitive, I use formula instead. If she is offering the milk to you like that then perhaps she just wants to be helpful? If you are going to make her an offer then just offer whatever it is that you can afford, but it doesn't seem necessary since your babies are stilll getting a good portion of breastmilk from you.

 

Have you considered trying to up your own supply?

[Pretty in Pink]

I'd look into domperidone...

 

OP, if you are interested in this PM me. I have a large supply that I ordered before my daughter was born and I was unable to use it.

[amey311]

Is that safe? From the FDA link posted, it looks like it gets into the breastmilk, and they think it might not be safe for babies... :confused:

 

Dr. Thomas Hale, PhD is a respected pharmacologist who deals with drugs and breastfeeding (prescription, OTC and even street drugs are covered in his book Medications and Mother's Milk). He provides real medication information. Here's what he has on Domperidone (trade name: Motilium) as well as Reglan (another drug used to increase milk supply, an off label use) and Sulpiride:

 

http://www.ibreastfeeding.com/content/newsletter/clinical-therapy-breastfeeding-patients

 

LRC: Lactation Risk Category (L1 being lowest, L5 being highest). I can copy the specific wording if you want to know.

 

RID: Relative Infant Dose which is calculated by dividing the infants's dose via milk by the mother's dose in mg/kg/day.

 

Pregnancy: the pregnancy risk category (A - D, and X, but there aren't letters between D and X. A is lowest risk).

 

AAP: American Academy of Pediatrics. They keep a list of "maternal medicines usually compatible with breastfeeding" (as well as drugs that aren't compatible, for example: some chemotherapy medications - it might be all of them, but I am not going to go look right now, and it's not relevant to this discussion).