One question many new parents have is whether they can take cold medicine while breastfeeding. “Luckily, there are many different over-the-counter cold [OTC] medicines that nursing parents can take safely,” says Dominique Gallo, IBCLC, a lactation consultant at The Breastfeeding Center for Greater Washington in Washington, DC. “In fact, pediatricians will prescribe many of them to the child to be taken directly if needed.” Here is what you need to know about treating a cold while breastfeeding, including which medications are safest and best for maintaining your milk supply.
What Is Cold Medicine?
There are many different types of OTC cold medicine, each targeting different symptoms, explains Joyce Yu-Chia Lee, Pharm.D., health sciences clinical professor at the University of California’s Irvine School of Pharmacy & Pharmaceutical Sciences. For body aches and fevers there are options like Advil (ibuprofen) and Tylenol (acetaminophen). For a runny nose or congestion, you can use a nasal spray like Afrin (oxymetazoline) or Flonase (fluticasone). “Oxymetazoline works by opening up the nostrils and decreasing the swelling of the blood vessels in the nose,” explains Dr. Lee. “Fluticasone opens up the nostrils by reducing the swelling or inflammation in the nasal passage.” To target coughing, you can take Robitussin (dextromethorphan). “Dextromethorphan suppresses the cough reflex by targeting the cough center in the brain,” Dr. Lee says. You can also try menthol cough drops, whose cooling sensation numbs the throat to soothe dryness and improve the cough reflex. To treat sneezing, runny nose, and itchy or watery eyes, there are antihistamines, such as Claritin (loratadine), Zyrtec (cetirizine), and Benadryl (diphenhydramine), which inhibit the immune system response that causes these symptoms. Finally, for head congestion and sinus pain, cold sufferers can take Sudafed (pseudoephedrine), a decongestant that narrows blood vessels to decrease congestion and swelling.
Is It Safe to Take Cold Medicine While Breastfeeding?
Most OTC cold medicines are OK for people who are breastfeeding to take as directed, with some caveats. While it seems safe in small amounts, Sudafed can occasionally cause irritability in babies and reduce milk supply, according to the National Institutes of Health (NIH) in its Drugs and Lactation Database (LactMed). The NIH advises against using Sudafed if you have yet to establish your milk supply. In any case, it’s important to talk to your doctor before using Sudafed while breastfeeding. In addition, when taken in large doses or over a prolonged period of time while breastfeeding, Benadryl can also reduce milk supply and may cause drowsiness in babies. Small occasional doses of Benadryl should not cause any adverse effects, according to the NIH, but be sure to check with a healthcare provider before using it or consider alternatives. Claritin or Zyrtec can be used in place of Benadryl, while there are natural methods that can help with congestion instead of turning to Sudafed. “I often suggest a humidifier, steam from the shower, or a neti-pot,” says Gallo. Other OTC cold medicines can be taken safely to get rid of cold symptoms as soon as possible, but it’s always good to run any medication use by your doctor and be sure to follow both physician and brand recommendations. “Always start with the lowest recommended dose first and use only on an as-needed basis to target specific symptoms,” Dr. Lee adds. Remember, cold medicine merely manages symptoms—it doesn’t treat the cold. “The best medicine to ‘cure’ the cold includes hydration and lots of rest, sleeping whenever possible or whenever baby sleeps,” notes Dr. Lee. “If cold symptoms persist and do not get better after six to seven days, do seek medical attention.”
Safety Precautions
For many cold medicines, using them responsibly, one at a time, and following the dosing instructions given is enough to ensure safety for you and your baby from any potential side effects. But experts do recommend keeping a few additional factors in mind before taking cold medicine while breastfeeding to treat your symptoms.
Avoid Drowsiness
Always be aware if drowsiness is a side effect of a medication you choose, because it may hamper your ability to care for your child. If a medication lists drowsiness as a possible side effect, make sure your partner or someone else is on hand to hold or watch the baby, advises Gallo.
Steer Clear of Multi-Symptom Drugs
While the majority of cold medicines are safe to use while breastfeeding, Dr. Lee doesn’t recommend combining them or choosing OTC options that have done that for you. “Avoid multi-symptom drugs or OTC drugs that consist of multiple ingredients to minimize unnecessary adverse effects,” she says. The more ingredients in a medication, the more possible side effects—plus you may be taking some drugs that you don’t actually need.
Choose Fast-Acting or Topical, When Possible
If you’re looking to be extra careful, there are additional steps you can take to minimize the amount of medication that makes it into your breast milk. “Ways to minimize medication exposure can also include selecting OTC cold medications with short-acting formulation, rather than 12-hour or 24-hour extended-release formulas, or to take the medications after feeds or after the last feed of the day, as appropriate,” suggests Dr. Lee. For colds that primarily consist of runny nose or congestion, go for the nasal spray. “Compared to oral drugs, topical products such as nasal sprays are less likely to pass into breast milk,” Dr. Lee says.
A Word From Verywell
The first year or so of your baby’s life takes a toll on your body and it’s not uncommon to come down with a cold at one point or another. If you do, feel free to treat your symptoms with an OTC cold medicine, as most are very safe, even when you are breastfeeding. Consider alternatives to Sudafed and Benadryl if low milk supply is an issue, and with any medication, check with your doctor first and follow recommendations for use. If cold symptoms persist or get worse after a week, or you’re unsure about any medications or have questions regarding your personal breastfeeding situation, don’t hesitate to reach out to your healthcare provider.
