What Flu Medicine Is Safe While Breastfeeding

Cold Medicine And Breastfeeding: Check With Your Doctor

Never take any medications, including common cold medications, without checking with your obstetrician or your child’s pediatrician. And even if side effects are minimal, it’s still best to be conservative when taking cough and cold medicine while breastfeeding.

Ross recommends that moms take as few doses as possible and space them out as much as possible while still managing the symptoms don’t casually take them every couple of hours to ward off symptoms. Take them when you need them without overdoing it, for your baby’s sake.

Lactation Risk Categories Explained

Drs. Thomas Hale and Kaytlin Krutsch have performed extensive research on the effects of medications in mothers milk. They have given each medication a rating from Safest to Hazardous .

L1 Safest: Extensive evidence demonstrating no adverse effects on the infant

L2 Safer: Limited evidence without an increase in adverse effects on the infant

L3 Probably Safe: No studies, but expert opinion suggesting safety. Risk to the infant is possible, and further evaluation must be taken to consider individual situations.

L4 Possibly Hazardous: Positive evidence or expert opinion of risk to the infant or milk production.

L5 Hazardous: Significant and documented risk to the infant.

Kaytlin Krutsch, PharmD, MBA, BCPS

Adapted from previous InfantRisk articles authored by James Abbey, MD, Erika Anderson, MS4, Thomas W. Hale, Ph.D., and Teresa Baker, MD.

References

1. Hale, Thomas Wright. Hale’s Medications & Mothers’ Milk, 2021: A Manual of Lactational Pharmacology. Springer Publishing Company, 2021.

2. Walsh P, Rothenberg SJ, Bang H. Safety of ibuprofen in infants younger than six months: A retrospective cohort study. Leong C, ed. PLOS ONE. 2018 13:e0199493. doi:10.1371/journal.pone.0199493

3.Findlay, Jw, et al. Pseudoephedrine and Triprolidine in Plasma and Breast Milk of Nursing Mothers. British Journal of Clinical Pharmacology, vol. 18, no. 6, 1984, pp. 901906., doi:10.1111/j.1365-2125.1984.tb02562.x.

Watch Out For These Ingredients

The following are not recommended for nursing parents. Always check with a healthcare provider before taking any new medications, because some medications can reduce your breast milk supply or affect your baby’s sleep.

Ingredients to avoid while breastfeeding include:

• Alcohol: Some remedies have alcohol to help you sleep, so skip those.
• DayQuil: DayQuil contains dextromethorphan, a cough suppressant, and phenylephrine, a decongestant, which can reduce your milk supply.
• NyQuil: NyQuil contains dextromethorphan, but instead of phenylephrine, it contains doxylamine, an antihistamine and sleep aid, which can reduce breast milk supply.
• Diphenhydramine : This drug may cause sleepiness, and prolonged use may decrease your milk supply. Breastfeeding babies can also become drowsy or irritable.
• Pseudoephedrine : Decongestants that contain phenylephrine or pseudoephedrine can dry up milk supply.

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When To See A Doctor

Most colds are mild and last between three and seven days. If your symptoms dont improve within this time span or worsen, make an appointment with your doctor. Sometimes, the common cold mimics other conditions or develops into a secondary infection. More serious symptoms to watch out for include wheezing, an earache, a severe cough, and facial pain. These symptoms may indicate one or more of the following conditions:

• ear infection

How To Take Cold Medicine Safely

Even though many typical cold medications can be taken by breastfeeding women, its still important to be mindful of any possible interactions, contraindications, and side effects of OTC drugs. And really, that goes for everyone!

You should always follow the dosing on the bottle, whether youre pregnant or not, Dr. Mello says. All drugs can cause side effects under the right circumstances. She adds that you should never take more than the recommended amount of a drug within the timeframe given on the packaging.

Even though taking single-symptom medication usually reduces the risk of complications for breastfeeding mothers, you also have to be careful when mixing and matching drugs make sure there are nodrug-to-drug interactions with other medications youre taking, or that you dont take two medications with the same ingredient. If youre unsure, ask your pharmacist about drug interactions for the medications you want to take.

As far as timing of your dosages, you may be able to orient them around your babys feeding schedule to further reduce the amount of medication that ends up in your breast milkthough this may not always be possible or even necessary, depending on the drug. The American Academy of Pediatrics says thatshort-acting medications are always preferable to long-acting ones. It may be helpful to write down names of medications, doses, and times taken.

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Sore Itchy Throat And/or Cough

• Drink strong black tea .
• Drink hot lemonade with honey. Or make a mixture of one part lemon juice and two parts honey. Sip throughout the day.
• Drink fenugreek tea to relieve head and chest congestion and cough.
• Use Zinc gluconate lozenges, but avoid taking large amounts of zinc for more than seven days, because it can interfere with other minerals in the body.
• Salt water gargle:Mix a 1 tablespoon of salt in eight ounces of warm water. Gargle the whole mixture several times a day.
• Apple-cider vinegar and water gargle.Mix 1-6 teaspoons vinegar in a glass of water you can mix it as strong as you can stand it. Gargle one mouthful . Repeat twice. Do this every hour, or as needed.
• Slippery elm bark can help with sore throat and cough. It comes in herbal cough drops and throat lozenges , or you can make a tea. For tea, use 1 to 3 teaspoons of powdered bark per cup, boil and simmer 15 minutes. Up to 3 cups per day.
• Chamomile tea gargle

Are There Natural Cold Remedies I Can Use While Breastfeeding

Sure! There are ways to help manage cold symptoms without medications while breastfeeding. Here are a few:

• Drink lots of water or other clear liquids. Clear liquids, especially warm ones, help break up mucus in your nose and chest. Adding honey or lemon to warm tea, or having sips of warm broth is a great way to get hydrated and relieve congestion.

• Take a hot, steamy shower. The steam from a hot shower can also help open up your sinuses and nasal passages. Even if you dont take a shower, standing in a bathroom full of steam from a hot running shower will help.

• Use a humidifier. A humidifier provides the same benefits as a steamy shower. Run a humidifier while youre sleeping to get some relief overnight.

• Try a saline nasal spray. If that congestion just wont go away, you can also consider a drug-free saline nasal spray. It uses the power of sterile saltwater to break up mucus in the nose.

• Rest. As a mom, rest might not be in your vocabulary as much as youd like anymore, but if possible, try to get a bit more rest while youre sick. Itll help your body kick that cold to the curb a little quicker.

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When Babies Have Colds

• Babies may want to feed frequently both for extra fluid and for comfort when they have cold symptoms.
• Babies with blocked noses may find it hard to feed and may keep coming off the breast. Sodium Chloride nasal drops used before feeds may help as may a manual decongester .
• Sometimes babies pull away from the breast and cry this may be because it increases in the pressure in their ears causing earache. This is particularly common overnight or after a longer sleep.
• Babies may have a croaky, hoarse cry which is different to normal, indicating a sore throat.
• Paracetamol can be given to babies older than 3 months .
• Ibuprofen can be given to babies older than 3 months.
• Historically paracetamol and ibuprofen were taken together but NICE recommended that this is not evidence based practice.
• Keep the atmosphere around the child moist by using vapourisers, steam generators or a damp towel over a radiator.
• If the parents have any concerns over the well-being of the baby medical advice should be sought urgently. It is better to err on the side of caution with young children whose condition can deteriorate rapidly.

Many of a babys symptoms can be taken to reflect a lower milk supply. Colds do not cause milk quality or quantity to diminish and breastfeeds can supply a great deal of comfort as well as nutrition to a child who is feeling poorly.

Safe Cold Medicine While Breastfeeding

In general, pseudoephedrine, dextromethorphan, NSAID pain relievers, acetaminophen, and second-generation allergy medications such as Zyrtec and Claritin are considered safe options for treating cold symptoms while breastfeeding. Per Dr. Mello, these drugs typically dont pass through breast milk in high enough quantities to cause side effects in your baby.

She does advise breastfeeding moms to avoidfirst-generation allergy medications like Benadryl, however, as they can cause sedation in your baby.

Its also important to pay attention to more than just the active ingredients. Other ingredients often included in common cold medications, especially cough syrups may be harmful. Many preparations contain a combination of dextromethorphan and ethanol , and those preparations should be avoided in breastfeeding, says Hannah R. Fudin, Pharm.D., a clinical pharmacist with the U.S. Department of Veterans Affairs.

Make sure tocheck the label of cough medications for alcohol before taking anything while breastfeeding while many dont include alcohol, there are still plenty of OTC medications, including cough syrups, that use it to increase the sedating effects of the medication.

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What Can I Take For A Cold While Breastfeeding

If you are breastfeeding, its important to be careful about what you put into your body, as what you ingest can enter your breast milk and thus be ingested by your baby.

While most cold medicines are safe to take while breastfeeding, make sure to first:

• Check with your doctor.
• Determine the active ingredient in the medicine.
• Check the correct dosage amount.
• Be prepared to monitor your baby for any behavioral or medical changes.

Generally, the amount of medicine that enters your milk when breastfeeding is much lower than the amount your baby would be exposed to while in your uterus.

However, because these drugs do enter your milk in small quantities, try to stick with the lowest possible dose you need to treat your symptoms. Also, to minimize any possible effects on your baby, you can feed your baby first and then take the medicine.

Prescription Antibiotics & Steroids

Antibiotics prescription only: In general, it is safe to breastfeed while on a short course . These medications typically transfer into milk in acceptable amounts. Some infants can be sensitive to even small amounts in their GI tract, causing diarrhea. If age appropriate, probiotics or yogurt with live cultures can be used to minimize GI upset . Common names: penicillins, cephalosporins, azithromycin

Steroids prescription only: Short term courses of oral or injectable steroids are unlikely to affect breastfed infants. Doses used for respiratory infections do not require any interruption to breastfeeding. Common names: methylprednisolone , prednison, prednisolone, budesonide , triamcinolone

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Complementary And Herbal Medicines While Breastfeeding

Complementary medicines include vitamins, herbal preparations, aromatherapy and homeopathic products. Like other medicines, complementary medicines can have side effects.

With most herbal and traditional medicines, there is not enough documented information to determine their safety in breastfeeding, so ask your health professional for advice.

Cold Medicine And Breastfeeding: Is It Safe

If you’re a breastfeeding mom, you know that what you put into your body goes directly into your baby’s. So does that mean cold medicine is off-limits?

After many long months of pregnancy, your body is yours again you can drink wine, eat sushi, and treat your aches, pains, and illnesses with a wider variety of medication.

But if you’re breastfeeding, that’s not necessarily the case. Remember that if you ingest it, so does your baby. So, if you have a common cold, is there potential harm for your child if you take cold medicine?

Unfortunately, less is known about the safety of medications while breastfeeding than during pregnancy. “With breastfeeding, there’s much less data,” says Elisa Ross, MD, an obstetrician and gynecologist on staff with the Cleveland Clinic in Ohio. The reason is that few women who are pregnant or breastfeeding are willing to participate in a clinical study to see if a medication will harm their baby what mom wants to do that?

But the U.S. Food and Drug Administration tracks reports of problems and makes recommendations on what’s probably safe and what’s been found to cause problems.

What we do know is this: Medications get into breast milk, but probably in smaller doses than what the mom is taking. Basically, says Dr. Ross, the baby will probably get only 10 percent of whatever dose mom takes when breastfeeding so there might be only one-tenth of the effect of the medication on the baby.

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Maybe Safe For Breastfeeding:

• Vitamin C: Theres a lot ofdebate over whether or not vitamin C helps anyone fight off colds, pregnant or not, but if youre a C-devotee wondering if you can increase your dosage during an illness, you should check with your doctor. While normal amounts of vitamin C seem to be fine, theres not a lot of research about extra doses of vitamin C, like the kind you might take to boost your immune system when sick. According toLactMed, the Drugs and Lactation Database, high doses are probably finebut its better to get the green light from your healthcare provider.

Whatever you choose, there is one thing you should definitely not do: Stop breastfeeding your baby out of fear of spreading germs through close contact. In fact, breastfeeding can protect your infant from illness.

Its okay to keep feeding your baby while youre sickyour body is making antibodies for the virus, which get passed through your breast milk, explains Dr. Mello. So keep your babys feedings, but if youre worried, wear a mask and add in some extra handwashing.

If youre unsure at all about the safety of any medication while breastfeeding, skip Google and give your provider or childs pediatrician a call, Dr. Mello suggests theyre much more likely to have accurate and up-to-date information about which drugs should and should not be taken if youre breastfeeding.

Can I Take Any Cold Medicine While Breastfeeding

Yes, there are cold medications that are safe to take while youre breastfeeding. Just be careful, because cold medicines often combine several drugs in one liquid or pill. To limit your babys exposure, avoid products that tackle more than one symptom or that have more than one active ingredient listed.

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Safe Cold Remedies For Nursing Moms

To start off, get as much rest as possible if youre battling a coldits all about giving your immune system a chance to fight back. These remedies may also help:

• Load up on vitamin C. Foods like oranges, tangerines, grapefruit, strawberries, melon, kiwi, mango, tomatoes, bell peppers, papaya, broccoli, red cabbage and spinach can boost your immune system.
• Amp up on zinc. Foods like turkey, beef, pork, cooked oysters, eggs, yogurt, wheat germ and oatmeal are loaded with zinc and can also help boost immunity.
• Stay hydrated. Drink plenty of water or warm soothing beverages like tea and broth to stay hydrated while youre sick. This can help the illness to pass more quickly.
• Switch on a humidifier. Dry air can make your cough worse. o Using a cool-mist humidifier to keep the air in your home moist can help relieve coughing.
• Try saline. Keep your nasal passages moisturized with saline drops, sprays or rinses.
• Choose safe medications. Cold medications that are safe to take when youre nursing include many decongestants as well as pain relievers like acetaminophen and ibuprofen . Talk to your doctor before taking any cold medicine to see what she recommends.

Can I Take Robitussin While Breastfeeding

Guaifenesin, an expectorant found in over-the-counter medications such as Robitussin and Mucinex, loosens mucus and makes it easier to breathe. Its OK to take while breastfeeding, and it wont affect your supply, but expectorants generally dont work that well, says Ellen Giesbrecht, senior medical director of the maternal newborn program at BC Womens Hospital, so they might not be worth taking.

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Cold Medications And Breastfeeding: Dos And Dont’s

Many over-the-counter cold medicine products are considered safe during pregnancy, when baby is directly impacted. So it’s generally considered safe for breastfeeding moms to take those medications with, of course, the same precautions.

Go with the ingredient that you need, not something that has lots of ingredients, and not something that has sustained release,” says Ross. A sustained release product means your baby will get the medication over a longer period of time. Choose medications with only one ingredient for the symptom that’s plaguing you most and avoid combination cough and common cold medicines that have ingredients for cough, sneezing, congestion, headache, and more.

Simple diphenhydramine and guaifenesin are fine, says Ross. And you can take ibuprofen and aspirin while breastfeeding, which were a no-no for pregnant women. Those drugs are “not shown to do damage to most newborn babies,” Ross says.

Of course, if your babys behavior changes more fussiness, for example consider that it could have something to do with your medication.

Ross says it’s also fine to use something like Vicks VapoRub or a saline mist. Just be careful that the Vicks doesn’t get on your breasts. It won’t affect your baby unless it gets on the breasts and the baby eats it.

Herbal medications and remedies are not recommended for breastfeeding women, as the FDA does not regulate them and their safety can’t be confirmed.