Medicine safe while breastfeeding?

Ask Anne…

Question: I’m nursing my three month old baby, and I’m having a hard time getting over a head cold.

Now I’m developing a cough. Is there any medicine that’s safe to take while breastfeeding?

Answer:  Most medications are safe for breastfeeding mothers. In  nearly all cases, the risk of side effects in your baby is extremely small.

When taking any medication during pregnancy or lactation, including cold and allergy preparations, it’s best to use single ingredient, short acting forms of the drug if possible.

For Sinus congestion:  Pseudoehpedrine is a nasal decongestant which is considered safe, as very little of it is excreted into breastmilk. Nearly all OTC cold medications include pseudoehpedrine. New research shows that it may decrease milk supply.  If a mother’s milk supply is low to begin with, she needs to be especially cautious when using medications containing pseudoephpredrine. These meds not been shown to be harmful to babies, but may decrease milk supply, especially if used by a mom with an older baby (six months or more), or used for extended periods of time.

If you want to use a nasal spray  to relieve sinus congestion, the majority of them are safe. Look for preparations that contain sodium chloride, oxymetazoline, or phenylephrine (such as Afrin, Breathe Free, or Dristan, or Neo-Synephrine). Avoid those containing propyhlexedrine (Benedrex). desoxyephedrine (Vicks Vapor Inhaler), or Lemetamfetamine (Nuprin Cold Relief Inhaler).

Most non-sedating antihistamines used for treating allergies are considered safe. Brand names include Claritin, Actifed, Zyrtec, and Allegra. You may find that sedating antihistamines like Benadryl make your baby sleepy and cause him to nurse less effectively.

Try to avoid long acting forms and multiple ingredients, and watch for drowsiness in the baby or a decrease in your milk supply. Drink extra fluids, because drugs that dry up secretions in other parts of your body may decrease your milk supply as well. Your supply will build up when you feel better.

For coughs: Avoid products with an alcohol content of over 20%. Robitussin, Mucinex, Triaminic Expectorant, and Vicks Nyquil are not known to be harmful, but watch for infant drowsiness. Expectorants like Guaifenesin(the main ingredient in Mucinex, Robitussin, Benylin) don’t suppress coughs. They loosen up the mucus in the respiratory tract to make it easier to cough up. They haven’t been known to cause any adverse effects in nursing babies, but they also don’t seem to be very effective. Avoid multi-action formulas such as Tylenol Multi-Symptom Cough medication and Vicks Nyquil Liquid or Liquicaps.

For more information, see Drugs and Breastfeeding.

I hope you feel better soon!

Anne Smith, IBCLC
Breastfeeding Basics