I have gotten so many messages recently asking if you can take cold medicine while breastfeeding. So many of us have been super careful, but somehow still managed to catch the latest Covid variant- myself included. If you find yourself needing to take some meds for relief, but you aren't sure what's safe to take, keep on reading.

Cold medicines while breastfeeding

While taking medication and breastfeeding, generally the "less is more" approach is best. As always, it's recommended you ask your doctor before taking any medication. If possible, use natural remedies first- but if needed here is some additional information provided from Kelly Mom, on using cold medication while breastfeeding. 

If you would like to know if you can take a specific cold medicines while breastfeeding , you can check breastfeeding compatibility on Infant Risk, or Thomas Hales, Medication and Mother's Milk or you can reach out to your lactation consultant.

• Use short acting medications when available 
• Use nasal spray medications rather than oral, when available
• Take medications immediately after you nurse and on an as needed basis.

Natural Remedies for Colds while Breastfeeding

These comfort measures are simply and generally considered safe to use while breastfeeding or chestfeeding. While these recommendations are not pharmacological, they may help improve some of the discomfort you are feeling if you are breastfeeding with Covid, or during a cold.

• Rest + Relaxation- drink plenty of water, use a humidifier, and take hot baths or steamy showers. 
• Add foods that are rich in vitamin C to your diet- like orange juice, broccoli or kale.
• Raw garlic- I know. I know. You can try adding it in a salad or chopped finely over roasted veggies. If raw is too much for you, try it cooked.

Sore Throat and Breastfeeding

There are plenty of options available to help soothe a sore throat while you are breastfeeding.

• Salt water gargle:  8 oz warm water + 1 Tbs salt and gargle and spit out the solution several times per day.
• Chamomile tea + gargle
• Lozenges and sore throat sprays are generally considered a safe option for nursing parents. You should avoid large amounts of cough drops that contain menthol. Menthol can lower your supply, which is likely already slightly lower if you aren't feeling well. 

Cough Medicine and Breastfeeding

If natural remedies aren't soothing your cough, you can consider some of the options below after speaking with your babies pediatrician.

• Cough drops are generally considered safe, just remember to avoid taking large amounts of cough drops with menthol.
• Information from Infant Risk
• Guaifenesin (L2):  This is an expectorant used to loosen respiratory tract secretions.  It does not suppress coughing.  The poor efficacy of expectorants in general would suggest that they do not provide enough justification for use in breastfeeding mothers.  However, untoward effects to the infants have not been described. Common trade names: Robitussin, Mucinex
• Dextromethorphan (L3): This is an antitussive drug that appears to work by elevating the cough threshold in the brain.  It is the safest of the antitussives and unlikely to transfer into milk.  Watch breastfed infants for drowsiness or poor feeding.  Common trade names: DM, Benylin, Delsym, Robitussin DM.
• Echinacea herbal supplement (L3). is an herb that has been shown to have significant antitussive effects when taken as an oral supplement.⁶ Although it is likely safe to take while breastfeeding, there have been no significant studies showing the effects of Echinacea consumption on breastfeeding infants or milk production.

Pain Medication and Breastfeeding

Unlike in pregnancy, both Acetaminophen (Tylenol) and Ibuprofen (Advil) are considered safe while breastfeeding. 

Naproxen (Aleve) should be used with extreme caution due to the long half line and effects on baby's systems. If you would prefer to use Naproxen, please consult with your baby's pediatrician. 

Aspirin should not be used while breastfeeding due to the risk of Reye's syndrome and bleeding.

Decongestants and Breastfeeding

While decongestants, like Sudafed and phenylephrine are generally considered to be a safe medication. Pseudoephedrine can reduce your milk supply. Dr. Hale, notes that parents with low supply, or with just enough milk should use be exceedingly cautious using pseudoephedrine and that parents who are in the later stages of breastfeeding may be more sensitive to this medication.

If you have taken pseudoephedrine and noticed a drop in your supply, typically the supply should rebound fairly quickly. Taking pseudoephedrine on a regular basis can lead to a permanent reduction in milk supply.

• Use saline nasal spray
• Essential oils (example: eucalyptus, peppermint, sage or balsam) Use for parent only. Do not diffuse oils around baby or apply to their skin. See more info on essential oils and babies here.
• Eat spicy foods

A note for Infant Risk on zinc supplements that are used to shorten colds and reduce severity. 

Zinc nutritional supplement (L2). Zinc can be used topically or ingested, and is usually not harmful when breastfeeding an older infant. However, doses of zinc in cold remedies can be in excess of what is safe. There is no accepted standard for what is too much, but the recommended daily allowance of zinc from all sources (including food) is 12 mg per day in a lactating woman.  Doses of commonly marketed zinc supplements frequently range from 8-25 mg taken every 3-4 hours. Total daily zinc consumption can become easily excessive with these products. Zinc salts for cold treatment can have possible negative effects on breastfeeding infants during the first weeks of life. Thus, excessive zinc supplementation in breastfeeding mothers should be avoided for the first month postpartum. Topical application of zinc oxide (like sunscreen) is not absorbed, and is safe when breastfeeding.  Common trade names: Galzin, Airborne, Orazinc, Zicam

If you have questions about medication you should consult with your doctor or OB. If you have questions about medication being passed through your breastmilk to baby, reach out to your baby's pediatrician or your lactation consultant. If you have used Feed Well lactation consultants in Columbia, MD, the Washington D.C. area, or virtually please feel free to reach out and we can check Hales Medication and Mothers' Milk and/or Infant Risk if needed.

We hope you are feeling better! If you feel that your supply has decreased while you are sick (common!!) and you need an appointment- feel free to book one today. 

Feed Well. Feel Better!