Almost any drug that's in your bloodstream will transfer to your breast milk. Most medications have no serious risks and transfer into the breast milk at very low levels. However, some medications can become concentrated and introduce a greater exposure of the medication in the breast milk.
Premature babies, newborns, and medically unstable babies are at the greatest risk for exposure to medication in breast milk. The risk is lower for healthy babies who are 6 months or older who can move drugs through their bodies more efficiently.
How to Know Which Cold and Allergy Meds Are Safe?
Check with your healthcare provider first if you're breastfeeding and plan to take medication. Avoid taking unnecessary medications, such as herbal medications, high-dose vitamins, and unusual supplements.
Also, ask your doctor about timing. For instance, taking the medication immediately after breastfeeding might help minimize your baby's exposure. However, different drugs peak in breast milk at different times.
Cold and allergy meds that are safe while breastfeeding include:
- Cetirizine (Zyrtec) and loratadine (Claritin) are the recommended antihistamines when breastfeeding. Other antihistamines are also considered safe but do not have as much research to support this. These include Allegra and Xyzal.
- Antihistamines such as Zatador are available as eye drops, which help itchy, watery eyes.
- A good option for nasal drainage is a saline nasal rinse. These rinses flush out allergens from the nasal passages. This helps to decrease drainage produced.
- Afrin (oxymetazoline) nasal spray is a nasal decongestant that can be used safely while breastfeeding. Because the medicine is not absorbed well from the nasal passages, it doesn't have the same effect on milk supply that decongestants taken by mouth can have.
- Flonase and Nasacort are nasal sprays that can help with sinus pressure and congestion. They are considered safe for breastmilk and babies but may take days or weeks to work.
- Tylenol (acetaminophen) is safe for babies and milk supply and may help mild to moderate pain or headaches.
- Motrin (ibuprofen) relieves both pain and inflammation. Motrin is one of the preferred anti-inflammatory medications when breastfeeding because it is processed quickly by the body and does not stay in a mother's milk long.
Some medications to avoid while breastfeeding include:
- Antihistamines, like Benadryl, have negative effects on breastfeeding and should be avoided if possible. Medicines like this decrease milk supply if used at high doses and for long periods of time.
- Sudafed can decrease milk supply and should also be avoided if possible.
Cold and Allergy Meds: What to Consider
When deciding which cold and allergy meds to take while breastfeeding consider:
- The risk the medication might have on your baby
- The benefits of the medication for your health
- The overall benefits of breastfeeding your baby
If you get sick and need to take medication that could affect your breastmilk, your doctor might recommend that you stop breastfeeding temporarily, depending on how long you need to take the medication. If this happens, you can pump in addition to breastfeeding to create an extra supply of breastmilk you can store in your fridge or freezer.
If you’re not sure if the medication you need to take is safe while breastfeeding, store your expressed breast milk in a separate area until you have a chance to talk with your doctor.
In rare cases, a doctor may ask you to stop breastfeeding permanently. Your doctor can help guide you through the process of weaning your baby off breast milk and transitioning them to baby formula.
Tips for Reducing the Transfer of Meds to Your Breastmilk
You can reduce the risk of your cold or allergy meds transferring to your breastmilk by:
- Using an alternative method of taking the drugs, such as a nasal spray instead of cold and flu tablets for a stuffy nose
- Using the lowest appropriate dose to manage your symptoms
- Taking your medication immediately after a feed or before your baby’s longest sleep period to minimize the amount of medication in your milk
- Choosing alternative medications whenever possible
- Expressing and discarding milk if you are only taking medications for a few days.
If you are breastfeeding and taking any medication, observe your baby for drug-related side effects such as irritability, sleepiness, poor feeding, or anything unusual or concerning with their behavior.
Always speak with your healthcare provider before taking any medication while breastfeeding.