Which cold and allergy medicines can I take while breastfeeding?

Which cold and allergy medicines can I take while breastfeeding?

Should you continue to breastfeed if you’re sick?

It’s perfectly fine to continue breastfeeding if you’re ill with a cold, flu, or stomach virus. You will not pass any germs to your baby through your breastmilk. In fact, there is some benefit to your baby as the milk will contain antibodies that you are producing against the infection, thus making your baby stronger and less likely to come down with the same illness.

In fact, it’s recommended that you continue to nurse as suddenly switching your baby off of your milk can stress them out, leading to increased susceptibility to getting sick.

The only thing you need to do is be careful of the medications you take. Some medicines can end up in your milk while others can decrease your milk supply. Tell your doctor that you’re breastfeeding!

Or if you’re going to take over the counter medicines, be sure to read the labels carefully and avoid the medicines (listed below0 that are known to affect your milk.

Medicines that work at the site without going through your bloodstream (ointments, nasal sprays, throat sprays, cough drops, eye drops) are the best choice as very little of the medication will end up in your plasma, thus very little of it will end up in your breastmilk.

You’ll also need to be careful about your fluid intake. It’s easy to fall behind and not drink enough water when you’re sick, but staying hydrated is very important for maintaining a healthy milk supply.

So without any further ado, here’s what you can take and what you should not take when you’re nursing.

Medications that can be taken while you breastfeed and will not affect your baby

  • Throat sprays, lozenges, and cough drops are generally safe. The only thing to watch out for is cough drops with large amounts of menthol. Too much menthol can reduce your milk supply. Most people won’t need to worry about getting too much menthol unless they’re eating multiple bags of cough drops every day.
  • Ibuprofen (Advil/Motrin) and acetaminophen (Tylenol) aka paracetamol are safe to take while you breastfeed.
  • Nasal sprays and containing corticosteroids and cromolyn sodium are safe to use as very little of the drugs end up in your blood.
  • Eye drops are also safe to use while breastfeeding.
  • Guaifenesin (Mucinex) can be used safely to treat coughs and as an expectorant to get rid of phlegm.

Medicines that are safe for breastfeeding mothers but can reduce milk supply

  • Common OTC decongestants containing pseudoephedrine, phenylephrine, phenylpropanolamine are safe for short term use while nursing, but be aware that long term use can decrease your prolactin levels. This will dry your milk supply. If you are prone to low milk supply or if you are close to weaning your baby, the effects of decongestants on your milk production will be strong. If you notice that the medications have dried up your milk production, stop taking them immediately and use techniques to increase your milk supply (extra pumping/nursing sessions, lecithin supplements, fenugreek supplements).

Medicines that will pass through breastmilk, but can be taken for short periods of time

  • Naproxen (Aleve) will end up in breastmilk, but can be used infrequently. Naproxen can affect baby’s GI tract and cardiovascular system, so it should only be used when all other pain relievers have been ruled out.
  • Diphenhydramine (Benadryl) will pass through your blood stream and into your breastmilk. While diphenhydramine is perfectly safe for your baby, it may be sedating. Cut back on the amount you’re taking if you notice your baby sleeping a lot while you’re taking this medication.
  • Loratidine (Claritin) and other non-sedating antihistamines are the best choice if you have to take medications for your allergies. Try to choose these over sedating antihistamines like Benadryl. Be sure to check the labels carefully as some antihistamines also contain pseudoephedrine which can affect your milk production.
  • Codeine cough syrups can be used for a short period of time, but should be avoided if possible since it can cause constipation and colic in your baby.

Medications to avoid while breastfeeding

  • Aspirin should not be used. Traces can pass through a nursing mother to her breastmilk. Aspirin in young children and infants can cause Reye’s syndrome and bleeding problems.

Natural remedies and care tips

  • A great way to clear your nasal passages and to relieve a dry cough is to drape a towel over your head and breathe in steam from a hot (not boiling!) bowl of water. Steam inhalation will relieve the worst symptoms of your illness instantly. You can also add a few drops of essential oils such as eucalyptus and peppermint to help clear your nasal passages.
  • Use a saline solution to help rinse out a stuffy nose.
  • Take extra doses of Echinacea during cold and flu season to boost your immune system. Garlic can also help fight off the common cold.
  • Lozenges containing zinc or vitamin C can also help your immunity.
  • Hot tea with lemon and honey will soothe a dry itchy throat. The caffeine will also constrict your blood vessels which will relieve a runny nose.
  • For a scratchy throat, gargle throughout the day with salt water (1 T salt to 1 cup water).
  • A soothing tea for scratchy and itchy throats and coughs is slippery elm bark and licorice root. If you don’t have these herbs on hand, the most convenient way to make this tea is with Throat Coat tea.

Additional resources

Cough and cold remedies and breastfeeding

Medications and breastfeeding: Current concepts by Frank J. Nice and Amy C. Luo


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