Sick with a cold? Safer medications for breastfeeding moms

If you’re sick with a cold while breastfeeding, there are several medications to manage your symptoms.

Being sick when you’re nursing is a miserable experience. Not only are you dealing the demands of a nursing baby or toddler, but you need to carefully consider what medications to take to lessen your symptoms.

There’s often confusion about what cold medications are safe to take when you are breastfeeding.

Nancy Holtzman, RN IBCLC CPN, sets the record straight using the premiere resources on the subject including Thomas Hale’s Infant Risk Center & Medications and Mother’s Milk, the US Government’s LactMed database and the American Academy of Pediatrics Medications Usually Compatible with Breastfeeding.

Keep it simple. Saline gargles and saline nasal sprays can help relieve cold symptoms, and a saline rinse such as a Netti Pot can help manage congestion and sinus pain, as well as sore throats caused by post-nasal drip. A cool mist humidifier, especially in the bedrooms, will help with congestion and sore throat symptoms. A spoonful of honey before bedtime truly can quiet an irritating cough.

But what can I take?
If you need something stronger, choose specific single ingredient medications to limit your use to what is truly necessary to treat your symptoms rather than using combination medications. Most “cough and cold” products like Advil Cough & Sinus or Nyquil, combine multiple medications you might not need. Instead, pick and choose each medication separately to manage symptoms as needed.

For fever, aches and pains, sore throat or sinus pain, you can safely take acetomenophen (Tylenol) or ibuprofen (Advil, Motrin). If you have sinus headache complaints, ibuprofen has an anti-inflammatory effect and is also slightly longer-lasting than acetaminophen.

For sneezing, runny nose and itchy eyes related to allergies, the antihistamine loratidine (Claritin) is usually considered safe to use. Diphenhyrdamine (Benedryl) is also considered safe for breastfeeding women, but can make you sleepy – not ideal when you have an infant to care for.

For congestion, using oxymetazoline (Afrin) Nasal Spray can effectively treat congestion from colds or allergies and is generally considered safe to use for nursing moms. Pseudoephedrine (the “real” Sudafed, available behind the counter in US) can decrease milk production and should be avoided in nursing moms. Decongestants containing Phenylephrine are a safer option in terms of maintaining milk production.  Read labels carefully. Saline rinses can help clear sinuses and reduce congestion.

For a cough, Dextromethorphan (Robitussin DM, Delsym) is considered safe for breastfeeding women and is used to quiet a cough. Guaifenesin (Mucinex) is an expectorant cough medicine, to help loosen phlegm and chest congestion and is considered to be approved for breastfeeding women. Read ingredients carefully as some cough medicines contain multiple ingredients including a decongestant. It’s better to select only the medications you truly need to control your symptoms.

For a sore throat, regular soothing lozenges are helpful but avoid large amounts of menthol. Treating congestion or runny noses may also help a sore throat caused by post-nasal drip so try saline rinses and and cool mist humidifier to reduce symptoms.  Hot tea with honey is soothing and has actually been shown by research to be effective as well.

Remember that you should continue breastfeeding even while you are sick.
Days before you noticed your symptoms or felt ill, your body was already responding to the viral invasion and has been busy creating antibodies to fight the infection. You’ll pass antibodies to your baby through your breastmilk. Nursing moms often find that even when a cold or infection runs through a household, the breastfed infant either resists the cold altogether or has a milder version than siblings or parents. So wash your hands well, stay hydrated, keep nursing and feel better soon!

Resources:
AAP Maternal Medications and Breastmilk
Free LactMed app for iPhone or Android
National Institute of Health ToxNet database search
Thomas Hale’s Infant Risk Center at Texas Tech University
Isis Parenting’s Breastfeeding Webinar Archived Recordings

Also see:
Helping Babies Manage Tiny Stuffy Noses
Managing Coughs and Colds during Pregnancy, Breastfeeding and for Infants and Toddlers

Nancy Holtzman, RN BSN IBCLC CPN

About Nancy Holtzman RN IBCLC CPN

Nancy is a Vice President at Isis Parenting and leads Clinical Content. As one of the original co-founders, she was instrumental in the creation of many prenatal and new parent programs at Isis Parenting, helping to develop the Isis vision in its earliest stages. Nancy has over 25 years of clinical nursing experience including ten years at Boston’s Beth Israel Hospital, and is a mother/baby nurse educator, a board certified lactation consultant and board certified pediatric nurse. She is the founder of the Great Beginnings New Mothers Group series which has now reached over 10,000 Boston-area mothers. She speaks and writes for a national audience about breastfeeding and infant development, and has served on the board of MLCA, the Massachusetts Lactation Consultants Association. She received a BS from Northeastern University College of Nursing, and a Certificate in Advanced Pediatric Assessment from Boston College. Nancy lives in Boston with her husband, two teens and a rescued Bichon. Find her tweeting about all about babies at @nancyholtzman

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