Breastfeeding With Allergy and Cold Season in Mind by Ida Hanson, IBCLC Candidate

April showers have arrived and May flowers are coming, but that also means that cold and allergy season is upon us! Before you pull up the covers and hit “add to cart”, consider what effects cold and allergy medications may have on your baby and your milk supply.

BREASTFEEDING friendly defenses against colds and allergies

Natural remedies are a great first line of defense against colds and allergies. Rest, hydration and a nutritionally dense diet are always important, but especially so when you’re not feeling your best. Try a warm bath to loosen up secretions or a humidifier in your bedroom. Hot tea with honey will soothe an irritated throat and regular Vitamin C intake can help shorten the duration of cold symptoms, so juice up!

Natural Remedies

If the warm bath soaks and hot tea just aren’t cutting it, you may find yourself reaching for an over the counter cold medication. Are they safe to take when breastfeeding though? Almost all medications that pass into your bloodstream will pass into your breast milk, but the actual amount that reaches the baby is typically extremely low. When taking an over the counter medication take it only when you need to, and only for a short amount of time. It’s best to choose medications that treat only the symptoms you have. Look for single ingredient formulas rather than multi-ingredient formulas that may have unnecessary multiple active ingredients.

TIPS FOR CHOOSE OTC options and what to avoid

What cold medications should be avoided while breastfeeding? Two common decongestants, pseudoephedrine and phenylephrine should be used with abundant caution. In oral and nasal preparations, they can dramatically decrease milk supply. One study has shown a drop in milk supply by 25% with just one 60mg dose of Sudafed®.1 Taking pseudoephedrine, especially over the long term, can permanently reduce your milk supply. If you take it for a short amount of time and notice a drop in supply, discontinue use and begin taking steps to increase milk production.

What about ahhhh-chooo! Antihistamines? Most antihistamines are compatible with breastfeeding, but as with any medication check the list of active ingredients before use. Antihistamines that make you drowsy, such as Benadryl®, can also make your baby drowsy, so generally non-drowsy antihistamines are preferred. Those include, but are not limited to, Claritin®, Allegra®, Zyrtec® and Flonase®. Be aware that the “D” versions of these medications do have the decongestant pseudoephedrine as an active ingredient, therefore use with caution.

If you have any questions about medications and compatibility with breastfeeding please rely on a trusted resource to help guide you. Resources that we recommend include LactMed® and the InfantRisk Call Center, and as always we are available to help at the Breastfeeding Center. If you have questions for our team, you can book an appointment here or text us at 202.293.5182 for more information.

Aljazaf K, Hale TW, Ilett KF, Hartmann PE, Mitoulas LR, Kristensen JH, Hackett LP. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol. 2003 Jul;56(1):18-24. doi: 10.1046/j.1365-2125.2003.01822.x. PMID: 12848771; PMCID: PMC1884328.

IDA HANSON IBCLC CANDIDATE/CLINICAL LACTATION INTERN

Ida is a military spouse who understands the importance of true community support when raising a family. After nursing school Ida worked with the pediatric special needs population before multiple moves around the world. In 2020 she reconnected with the maternal-child community and became a Certified Lactation Counselor. She worked as a trusted CLC at WIC until the Air Force moved she and her family to the Northern Virginia area. At the Breastfeeding Center of Greater Washington Ida continues her path to becoming an International Board Certified Lactation Consultant under the mentorship of the highly skilled IBCLCs on staff. She is honored to be an IBCLC candidate and to provide practical, evidence-based lactation care to families during their breastfeeding journey.

Natural Remedies for Colds and Allergies:

  • Rest, hydration, and a nutritionally dense diet are essential.

  • Try a warm bath or a humidifier in your bedroom.

  • Hot tea with honey can soothe an irritated throat.

  • Regular Vitamin C intake may help shorten the duration of cold symptoms.

when choosing an OTC Cold Medications Safe for Breastfeeding:

  • Single-ingredient formulas are preferred.

  • Check the list of active ingredients before use.

  • Choose medications that treat only the symptoms you have.

  • Opt for non-drowsy antihistamines if needed. (Examples: Claritin®, Allegra®, Zyrtec®, Flonase®)

Cold Medications to Avoid While Breastfeeding:

  • Avoid multi-ingredient formulas with unnecessary active ingredients. (Examples: Sudafed®)

  • Phenylephrine

  • Pseudoephedrine



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