It's safe to breastfeed your baby when you're sick, but it certainly isn't fun. If you're wondering whether an over-the-counter cold medicine or pain reliever is okay to take, good news: Most options are safe for nursing moms and babies.
That said, there are some important caveats to keep in mind (and a few meds you might want to avoid outright). Here's a quick primer on what you can and shouldn't take to feel better.
Is cold medicine safe to take while you're breastfeeding?
Most over-the-counter cold medications are safe to use when you're breastfeeding, according to the American College of Obstetricians and Gynecologists (ACOG).[1]
While medications can be passed through to your baby from your breast milk, the amount is thought to be very small — only around 1%.
"It's normal to feel cautious. We always want to ensure that moms feels healthy; treating your symptoms can help you stay well enough to care for your baby," says Florencia Segura, M.D., a pediatrician in Vienna, Virginia, fellow of the American Academy of Pediatrics (AAP), and member of the What to Expect Medical Review Board.
Meds that generally get the green light for breastfeeding moms include:
Antihistamines such as cetirizine (Zyrtec), fexofenadine (Allegra), loratidine (Claritin), and diphenhydramine (Benadryl) (all of these might make your baby drowsy, however)
Cough medicines like dextromethorphan (DayQuil, Delsym)
Expectorants like guaifenesin (Mucinex, Robitussin)
Nasal decongestants like oxymetazoline (Afrin)
Pain relievers including acetaminophen (Tylenol) and Ibuprofen (Advil, Motrin)
You can also follow a few simple rules of thumb to make sure your baby is exposed to as little medication as possible:
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Only take meds when you really need them. If a safe home remedy like nasal saline spray, steam, and hydration can relieve your symptoms, opt for that instead.
Take the smallest dose for the shortest amount of time. Avoid extended-strength or sustained-release formulas, which stay in your system longer.
Take meds right after breastfeeding. Your baby will generally be exposed to less medication if you dose up right after nursing.
Choose single-ingredient meds over multi-symptom formulas. If you're not sure what's in a medication, check the active ingredients list to confirm.
Before taking a new medication, you should always weigh the benefits and risks of a given medicine with your baby's pediatrician, recommends the AAP. [2]
Checking with the doctor is especially important if your baby is a newborn or a preemie, has a serious medical condition, or has kidney problems, since he may be more vulnerable to the effects of certain drugs. Together, you can come up with a symptom-relief plan that you feel good about.
If you'd like to learn more about a certain medication, you can also check evidence-based resources like LactMed. "It provides data on potential adverse effects of breastfeeding infants and lactation, case reports of infant exposures, and recommendations for alternative medications," Dr. Segura says.
Cold medicines to avoid when you're breastfeeding
While most cold meds get the thumbs up when you're nursing, there are a few that you'll want to steer clear of. These include:
Pseudoephedrine (Sudafed, Allegra-D)
Phenylephrine (Sudafed, Neo-Synephrine)
Aspirin because of the risk of Reye syndrome in infants
Multi-symptom cold meds, since some may contain alcohol or other drugs that may not be safe
High-dose vitamins
- Certain supplements, including echinacea and elderberry
Pseudoephedrine and phenylephrine aren't thought to be unsafe for babies. But both decongestants can lower your milk supply by around 25% for up to 24 hours after taking them, according to LactMed.
“While many [cold meds] are safe to take, be careful as [some] decongestants and antihistamines can dry up milk supply in addition to helping with cold symptoms,” advises What to Expect Community member lks314 in response to another mom’s question about what cold medications are okay when you’re nursing.
As for vitamins, herbal remedies, and supplements? There simply isn't enough evidence to say whether these options are safe for nursing moms and babies. So for now, it's best to skip them.
Options for treating cold and flu symptoms while breastfeeding
Whether you'd prefer to avoid taking medicine or are looking for some additional relief, these are some more ways to soothe your symptoms.
Stay hydrated. Drinking enough helps you stay hydrated while helping to relieve congestion. Water, tea, clear broth, and juice all count. Try to steer clear of caffeine or alcohol, which can make you more dehydrated.
Try to eat wholesome foods. Options rich in vitamin C (like oranges, grapefruit, and strawberries) and zinc (like eggs, turkey, yogurt, and oatmeal) can support your immune system.
Sip some tea. It's hydrating, plus the warmth helps your throat feel better. For extra relief, "boil ginger and add lemon and honey once the tea cools down to room temperature," recommends What to Expect Community mom stolichnaya01.
Ask for help so you can rest. When possible, try to get some extra sleep by having someone else take the baby when you're not breastfeeding.
Gargle with salt water. You can make a comforting throat rinse by mixing 1/4 to 1/2 teaspoon salt with 8 ounces of water.
Try saline drops. A few drops in each nostril can temporarily curb stuffiness.
Run a humidifier. Keep one next to your bed or by your side while you're nursing. The extra steam can help break up congestion.
With the exception of a handful of drugs that could affect your milk supply, there's generally no harm in taking most cold medicines while breastfeeding when you really need some relief. Just check with your baby's pediatrician first for extra peace of mind.
Most cold medicines are safe to use when breastfeeding. Take the smallest dose for the least amount of time, and try to take your meds right after breastfeeding. Always check with your doctor before taking any medication.
Avoid pseudoephedrine and phenylephrine. They can cause supply dips.
Don't assume herbal remedies are safer. Even though they're natural, they haven't been proven safe for breastfeeding moms and infants.
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