The common cold will usually run its course within 7 to 14 days. There are many natural remedies and over the counter products that are compatible with breastfeeding. Image credit: Jerry Bunker on flickr Natural RemediesGeneral
Head congestion
Chest congestion
Sore, itchy throat and/or cough
Medications generally regarded as safeGeneral guidelines
The current edition of Medications and Mothers’ Milk by Thomas Hale, PhD has information on many cold medications (including specific guidance on combination products) in the Appendix. Many of the active ingredients in cold and allergy medications are listed below. Now infants can get Cough & sore throat meds
Pain medsBoth Advil/Motrin (Ibuprofen) and Tylenol (Acetaminophen) are considered compatible with breastfeeding. Aleve (Naproxen) is also AAP-approved for nursing mothers, but (per Hale) should be used with caution due to its long half-life and its effect on baby’s cardiovascular system, kidneys and GI tract; short-term, infrequent or occasional use is not necessarily incompatible with breastfeeding. Aspirin use is discouraged in children due to the risk of Reye’s syndrome. Although the risk is probably low, it is also discouraged in nursing mothers because of the potential risk of Reye’s syndrome and bleeding. Eye dropsEye drops designed for cold/allergy symptom relief are considered compatible with breastfeeding. Nasal sprays or gelsNasal sprays are generally considered compatible with breastfeeding. Decongestant nasal sprays are generally for short-term use (3-7 days) only; consult your health care provider and the package instructions for specific information. Of the preparations available for treatment of allergic symptoms, corticosteroid nasal sprays (e.g., Flonase, Nasacort, etc.) and cromolyn sodium nasal spray (a mast cell stabilizer, e.g., Nasalcrom) are considered to be, by far, some of the most effective and safest to use in breastfeeding moms. The plasma levels of these drugs are extremely low, and thus milk levels would be even lower. A homeopathic nasal gel, made by Zicam and containing ionic zinc gluconate, was recalled by the US FDA in 2009 because it has been associated with long lasting or permanent loss of smell (anosmia) [this is not related to lactation – see the FDA information page and Jafek BW, Linschoten MR, Murrow BW. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004 May-Jun;18(3):137-41]. Zicam contains small amounts of zinc (Zincum Gluconicum) – 266 micrograms per squirt; in one study (Mossad 2003) the daily dosage used was 2.1 mg per day. Zinc is considered compatible with breastfeeding, particularly in small amounts (excessive amounts are not a good idea, for mom’s sake rather than baby’s). The amount of systemic absorption of nasal sprays/gels is minimal compared to oral ingestion. DecongestantsBoth pseudoephedrine and phenylephrine are generally considered to be safe for the breastfed baby, but pseudoephedrine may reduce milk supply. Pseudoephedrine & milk supply: Thomas Hale Ph. D., a renowned breastfeeding pharmacologist (Breastfeeding Pharmacology), notes that “breastfeeding mothers with poor or marginal milk production should be exceedingly cautious in using pseudoephedrine” and that “it is apparent that mothers in late-stage lactation may be more sensitive to pseudoephedrine and have greater loss in milk production” (Medications and Mother’s Milk, 2012 edition). Dr. Hale is referring to this study: Aljazaf K, et. al. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. Br J Clin Pharmacol. 2003 Jul;56(1):18-24. If you do take pseudoephedrine and notice a drop in milk supply (many moms do not, but research shows that it can decrease milk supply by as much as 24%), simply stop the medication and take measures to increase milk supply – the problem should resolve fairly quickly. Be very cautious about taking pseudoephedrine on a regular basis, as it has the potential to permanently decrease your milk supply. Regular use of pseudoephedrine (120 mg/day) has occasionally been used to decrease milk production in moms with overproduction, where the usual methods to regulate milk production were not working. AntihistaminesMom’s use of sedating antihistamines (including Benadryl and Chlor-Trimeton products) are generally regarded to be compatible with breastfeeding, but always double-check the active ingredients as they can vary greatly. Monitor your infant for possible drowsiness if you use this type of antihistamine. The non-sedating antihistamines (below) are generally preferred and are less likely to sedate baby. The ingredients of Claritin, Claritin-D, Clarinex, Allegra, Allegra-D, and Zyrtec are generally regarded to be compatible with breastfeeding (again – always double-check the active ingredients). Loratadine (Claritin) has been studied and the amount of loratadine that passes into breastmilk is extremely low. Claritin-D and Allegra-D have the decongestant pseudoephedrine added (see above about possible effect on milk supply). Dr. Hale has said that he prefers the non-sedating antihistamines (even though they are long-acting) over the sedating allergy medications. Milk supply: A common concern is that the sedating antihistamines might lower milk supply but, per Dr. Thomas Hale, there is no current research supporting this belief – only some anecdotal reports. If you feel that your supply has decreased, it could simply be a byproduct of decreased nursing frequency or dehydration due to your illness. If you feel that a medication is the cause of a sudden drop in milk supply, then stop taking (or decrease your use of) the medication – if the med is indeed the cause, then supply should increase again soon after you stop taking it. When using an antihistamine, it can be helpful to step up your fluid intake quite a bit. As with any medication, take it only as needed, and discontinue use as soon as you can. Links for additional informationGeneralNatural RemediesMedications
What can I take for a cold 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.
Is DayQuil cold and flu safe for breastfeeding?It's best not to take Dayquil or Nyquil while breastfeeding.
Can breastfeeding mothers take cold medicine?But there's good news: It's okay to use most cold medicine while breastfeeding, even those that were off-limits during pregnancy.
What cold and sinus medications are safe while breastfeeding?Flonase and Nasacort are nasal sprays that can help with sinus pressure and congestion. They are considered safe for breastmilk and babies but may take days or weeks to work. Tylenol (acetaminophen) is safe for babies and milk supply and may help mild to moderate pain or headaches.
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