What to Know About Taking Cold Medicine While Breastfeeding

Choosing to take cough syrup or a decongestant when you’re sick doesn’t usually qualify as a major decision. You’re feeling unwell, so you take immediate action—no second guessing required. But when you’re breastfeeding, taking any medication can feel like a big deal. Should you skip the pills and keep feeling miserable—or get some relief and give baby a side of Sudafed?

Turns out, the choice of whether to take cold medicine while breastfeeding doesn’t have to be fraught. While some drugs do come with possible side effects, most are considered safe. Read on to learn which cold meds are okay to take when you’re nursing, and which ones you should avoid—plus answers to all your burning questions about breastfeeding when you’re sick.

Breastfeeding While Sick

Don’t worry, you aren’t putting baby at risk by nursing when you’re feeling unwell. “Not only is it safe to continue breastfeeding while you’re sick, it’s actually a really good idea to do so,” says [Chrisie Rosenthal], IBCLC, a Los Angeles-based lactation consultant.

It’s understandable that you might worry about possibly transmitting your germs to baby by continuing to nurse. After all, breastfeeding is all about close contact and the sharing of bodily fluids. Here’s the thing: By the time you notice your symptoms coming on, baby has already been exposed. And breastfeeding can actually help them stay healthy—or, at least, get better quicker—since your milk serves up protective antibodies designed to fight off an infection, according to the American Academy of Pediatrics (AAP).

Continuing to breastfeed through a cold or virus also helps ensure that your supply doesn’t take a dip. Remember, milk production is all about supply and demand, and stopping nursing for a day or two could send your body the signal to start making less since baby isn’t eating as much, notes La Leche League.

That’s not to say it’s going to be easy. Catering to the whims of another person’s hunger 24/7 is always a big job—and it’s even harder when you feel like garbage. Drinking plenty of clear fluids like water, tea or chicken broth can help. Being sick makes you prone to dehydration, and a steady stream of liquids can help you feel better and keep up your milk supply, which can drop when you don’t drink enough.

Finally, try to rest when you can. “Bring in support if possible so you can get that extra sleep,” Rosenthal says. Ask a family member or friend to come by for a few hours during the day so you can nap between feedings—or have your partner take over so you can get to bed early.

Cold Medicines That Are Safe For Breastfeeding

If you’re worriedly asking yourself: “What cold medicine can I take while breastfeeding?” rest assured that we’ve got good news. It turns out, you have more options than you probably think. While it’s always a good idea to discuss the risks and benefits of taking any medication with your doctor, ultimately, the majority of over-the-counter drugs are safe to take, according to the AAP and the Centers for Disease Control and Prevention (CDC).

Wondering if the ingredients in a medication can be transferred through your breast milk? The short answer is yes. But most won’t have a negative impact on your little one, notes the CDC. “Milk supply is actually a bigger concern than transfer of medication to baby,” says Rebekah Diamond, MD, an assistant professor of pediatrics at Columbia University Irving Medical Center in New York, and the author of Parent Like a Pediatrician. That’s because medications designed to dry up mucus, like some decongestants and cough medicines, can sometimes also have a drying effect throughout the rest of your body, she adds.

But even then, it’s not like taking a dose or two of a decongestant or cough suppressant is going to completely turn off your milk production. “I’ve never seen them have an immediate, dramatic effect,” says Rosenthal. “I’d be concerned if someone was using those medications for long periods. But with a one-time use, it’s not like your milk is going to be gone tomorrow.” (And if it does taper down a bit, there are ways to bring it back up.)

So which cold meds get the green light? According to the National Drugs and Lactation Database (LactMed), these OTC options are generally considered safe for breastfeeding moms and their babies:

Safe decongestants for breastfeeding moms

• Dextromethorphan. This cold medicine is considered safe for breastfeeding moms and babies. Options like Robitussin, Delsym, Triaminic and Vicks DayQuil Cough are unlikely to affect your supply and have no reported infant side effects.
• Pseudoephedrine. Another cold medicine safe for breastfeeding moms and their little ones is pseudoephedrine, the active ingredient in Sudafed and Allegra D. It’s true that these medications can cause a dip in milk production, but they’re unlikely to cause a major supply problem—unless you use them long-term. They might make baby a little cranky though; one study found that 20 percent of babies whose mothers took pseudoephedrine became irritable.
• Oxymetazoline. Thinking of taking Afrin or Nasacort? No research has been conducted on oxymetazoline and breastfeeding, but it’s likely that only a tiny amount will be transferred to your infant, since it’s administered as a nasal spray. It’s recommended over pseudoephedrine because it’s less likely to affect your supply.
• Phenylephrine. Suphedrine or other medications with the active ingredient phenylephrine are unlikely to pose a risk to baby. But since there’s no research specific to breastfeeding, it might not be your first choice.
• Guaifenesin. If you have Mucinex, Robitussin, Tussin or Vicks DayQuil on hand, know that there’s no breastfeeding-specific research on the active ingredient Guaifenesin, but it’s unlikely to pose any harm to infants, especially those over 2 months. Again, this probably shouldn’t be your first choice, but it’s generally considered acceptable for occasional use.

Safe pain relievers for breastfeeding moms

• Ibuprofen. Advil or Motrin are the best options for symptoms like fever or a headache, since infants can tolerate higher doses, and much lower levels end up in breast milk.
• Acetaminophen. Tylenol is a good choice, since it’s unlikely to cause side effects in babies. (There’s a reason they give this to new moms in the hospital!)
• Naproxen sodium. Aleve is generally considered safe, but not as preferred as ibuprofen or acetaminophen, since it stays in your system (and baby’s) for longer.

Safe antihistamines for breastfeeding moms

• Loratadine. Options like Claritin or Alavert might make your supply dip a bit, but they’re unlikely to cause side effects in babies.
• Fexofenadine. Same story as loratadine: Allegra Allergy—or other options with the active ingredient fexofenadine—might affect your supply, but they won’t affect your little one.
• Diphenhydramine. Benadryl is safe for breastfed babies, and the occasional dose probably won’t affect your supply. But using it regularly might lead to decreased production. You and baby might feel drowsy too.

Cold Medicines to Avoid While Breastfeeding

A handful of cold medicines come with more risks than benefits for breastfeeding moms and babies. That’s not to say they’re 100 percent off limits: “There’s no such thing as ‘always safe’ and ‘never safe.’ It depends on the situation,” says Diamond. But if you’re considering taking one of these, it’s crucial to talk about the pros and cons with your doctor first:

• Codeine. The active ingredient in Tuzistra, Demi-Cof, Dex-Tuss and Tussirex can accumulate in an infant’s system when a breastfeeding mom takes a normal dose. This can potentially cause dangerous side effects like trouble breathing or a slow heart rate, notes the AAP.
• Hydrocodone. High levels of hydrocodone—found in Hysingla and Zohydro ER—is transferred to babies through breast milk, so the AAP recommends using these options with caution. Aspirin. Doses above 162 mg per day can cause high levels of aspirin to accumulate in baby’s system. (Lower doses may be safe.) Aspirin can also cause rashes or bleeding problems in babies, according to the AAP

Tips For Taking Cold Medicine While Breastfeeding

Do you need to pump and dump? When’s the best time to dose? If you opt to take an over-the-counter cold medicine while breastfeeding, keep these tips in mind:

• See if a nasal spray will help. If you’re mainly dealing with stuffiness, try a nasal spray like Afrin or Nasacon to see if that helps first, Rosenthal recommends. Less of the medication will transfer to your milk, compared to an oral product, which means your supply is less likely to be affected.
• Take the medication after nursing if you can, but don’t stress. Sure, dosing right after a breastfeeding session may mean that less of the medication is transferred to baby by the time they’re ready to nurse again. But that’s not necessarily the case, since some meds are metabolized slower than others. Bottom line? “Trying to figure out the timing is way too complicated and not necessary to worry about,” Diamond says.
• Don’t worry about pumping and dumping. The practice is totally outdated, says Rosenthal. Remember, if you’re taking a medication, you and your doctor should already have discussed whether it’s safe for you and baby.
• Add pumping sessions if you notice your supply dropping. Rosenthal recommends pumping for 10 minutes after nursing, if it seems like a medication is having a negative impact on your supply. But, if your milk supply seems fine, don’t worry about doing it preventively. “Oversupply is as big of an issue as undersupply, so don’t overstimulate if you don’t need it,” she says.
• Avoid combo meds. Medications that combat multiple symptoms (like cough suppressants that also help you sleep) contain multiple active ingredients, which makes it harder to keep track of what you’re taking.
• Avoid long-acting medications. They typically have higher doses, so they may be more likely to affect your supply. “You always want to take the dose that’s just enough to be effective to keep side effects lower,” says Rosenthal.
• Don’t feel guilty. There’s nothing wrong with taking an approved cold medicine while breastfeeding to get the relief you need. “It’s really, really okay to take care of yourself,” says Diamond.

Cold Remedies That Are Safe For Breastfeeding

Don’t want to take a cold medicine while breastfeeding—or want to see if you can curb symptoms before popping a pill? There are plenty of natural ways to manage your symptoms too. Whether you opt to take a cold medicine or not, these home remedies recommended by the Mayo Clinic can help you find relief:

• Drink plenty of liquids. Water, tea or broth will help you stay hydrated and work to break up mucus. Steer clear of coffee and alcohol, which will only dry you out more.
• Take it easy. Even if you can’t take the two-hour nap you’re dreaming about, you don’t have to run errands or take baby to music class. Try to just chill. (Easier said than done, we know!)
• Gargle salt water. Dissolve 1/4 to 1/2 teaspoon of salt in warm water and swish it around your throat. It can help with scratchiness.
• Sip hot tea with honey. The combo is another satisfying throat soother.
• Run a humidifier. It adds moisture into the air, which can help relieve congestion.

Taking a safe cold medicine while breastfeeding can give you relief and help you function better—so that you can take care of baby. Talk to your doctor if you have any concerns about your supply or baby’s exposure to certain active ingredients.

Plus, from The Bump:

Is CBD Safe for Breastfeeding Moms? What You Need to Know

Are There Foods to Avoid While Breastfeeding?

What to Expect at Each Stage of Breastfeeding

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.