Which Cold Medicine Can You Take While Breastfeeding?

Beware DayQuil, NyQuil, Benadryl, and Sudafed

Medically reviewed by Lauren Schlanger, MD

Breastfeeding when you have a cold is generally safe and may help boost the baby's immune system. However, some allergy, cold, and flu medicines may not be safe to take while breastfeeding.

Over-the-counter (OTC) pain relievers and non-drowsy antihistamines are generally okay, but you should avoid NyQuil, Benadryl, Sudafed, and DayQuil while breastfeeding. These drugs can hinder your supply, harm the baby, or make it unsafe for you to hold your baby.

This article discusses which cold medications are safe and which to avoid if you are breastfeeding.

Can I Breastfeed While Sick?

Yes, you can breastfeed even if you're sick. Breastfeeding while sick is still healthy for you and your baby. Continuing to breastfeed is also a good reminder to keep yourself fully hydrated. You need ample hydration to make breast milk, and it also helps relieve symptoms.

Things to consider with breastfeeding while sick include:

• Age of the infant

• Potential effects of the drug on breast milk production

• Amount of the drug that will enter the milk supply

• Proportion of the baby's milk intake that is from breastfeeding

Premature babies and newborns are most at risk for being negatively affected by medicine in breast milk, but the risk goes down around 2 months of age.

Drugs and Lactation (LactMed) Database

The Drugs and Lactation (LactMed) database is a useful resource for parents. It's a searchable database that contains information on drugs and other chemicals breastfeeding parents and their babies may be exposed to.

Benefits of Breastfeeding for Immune Health

Breastfeeding has a number of benefits for the baby and the nursing parent. Your body produces antibodies that are passed to your baby, which then protect them from your cold or viral infection.

If you are too sick or weak to breastfeed, you might try pumping milk to keep up your supply.

Supplementing with baby formula is also an option, and it's absolutely safe. If you are unable to breastfeed, your baby can receive the nutrients they need from formula.

Cold and Allergy Medicine Safe for Breastfeeding

The following medicines are considered safe for nursing parents, but it's always a good idea to check with a healthcare provider or pediatrician before taking any new medications. Some medications can reduce your milk supply.

Pain and Fever Reducers

Pain relievers and fever reducers that are safe to take while breastfeeding include:

• Tylenol (acetaminophen)
  

• Advil, Motrin (ibuprofen)

• Aleve (naproxen)

Acetaminophen and NSAIDs (ibuprofen, naproxen) can be taken together. However, avoid taking more than one NSAID or more than one product containing acetaminophen at a time. Excessive doses of NSAIDs can cause an upset stomach, while too much acetaminophen can harm your liver.

Antihistamines

Allergy medicines help reduce symptoms such as itchy eyes, sneezing, and a runny nose. Safe options to take while breastfeeding include:

• Claritin (loratadine): Claritin is safe to use based on supporting data but may have a negative effect on your milk supply when combined with a decongestant such as Sudafed (pseudoephedrine).

• Zyrtec (cetirizine): Zyrtec is safe in occasional, small doses, but in large doses, it can reduce milk supply.
  

• Allegra Allergy (fexofenadine): Allegra is safe in occasional, small doses, but it may have a negative effect on milk supply when combined with a decongestant such as Sudafed.

Cough Medicine

Cough suppressants and expectorants are generally safe to take while breastfeeding. Some cough medicines may contain alcohol, which should be avoided.

Cough medicine ingredients you can take on a short-term basis while breastfeeding include:

• Dextromethorphan: A cough suppressant found in medications labeled DM

• Guaifenesin: An expectorant sold under the brand name Mucinex and in generic formulas

Decongestants

Oral decongestants can interfere with your milk supply and may not be safe for your baby.

Decongestant nasal sprays are safer because they are delivered straight to the source of congestion. They are not likely to enter the milk supply or hinder milk production.

Oxymetazoline is the primary ingredient found in decongestant nasal sprays sold under the brand names:

• Afrin

• Zycam Nasal Spray

Oxymetazoline should not be used:

• For more than three days because your body can become dependent on it

• When nursing infants with cardiac symptoms or high blood pressure

Can You Take Antibiotics While Breastfeeding?

Antibiotics are generally safe to take during breastfeeding, but some are safer than others. For example, metronidazole should not be taken while breastfeeding. Ofloxacin and gentamycin should be used with caution and only when no other options are available.

Antibiotics can pass to the baby in breast milk and cause diarrhea and oral thrush. Some antibiotics, like penicillin, carry a risk of allergic reaction and should be used with caution.

Medications to Avoid

Cold and flu medications may contain ingredients that should not be taken or should be used with caution while breastfeeding. Some can reduce your breast milk supply or affect your baby's sleep or mood. Others cause drowsiness, which may make it unsafe for you to nurse.

Cold medicine ingredients to avoid while breastfeeding include:

• Alcohol: Can harm baby's development; avoid nursing for 2 to 3 hours after consuming alcohol.

• Codeine: Causes drowsiness in nursing parent and child; may cause severe central nervous system depression, difficulty breathing, and infant death.

• Diphenhydramine: May cause dizziness and drowsiness; larger doses can hinder milk production and cause the baby to be irritable.

• Doxylamine: May cause drowsiness; larger doses can hinder milk production.

• Hydrocodone: Causes drowsiness in nursing parent and child; may cause severe central nervous system depression.

• Phenylephrine: May hinder milk production; effect on infants unknown.

• Pseudoephedrine: May hinder milk production and cause the baby to be irritable.

Read the Ingredients

Look at the ingredients list on the packaging before taking any medication. Not all ingredients have been studied for safety in breastfeeding people, and healthcare providers urge caution when deciding which medications to take to treat a cold or flu.

Benedryl

Benedryl is a brand name of diphenhydramine. This drug may cause sleepiness, and prolonged use may decrease your milk supply. Breastfeeding babies can also become drowsy or irritable.

DayQuil

DayQuil contains phenylephrine, a decongestant, which can reduce your milk supply. In addition, phenylephrine has not been studied on nursing infants, so its safety profile is unknown.

NyQuil

NyQuil contains alcohol and doxylamine, an antihistamine and sleep aid. Taking NyQuil can make you drowsy, making it unsafe to hold or nurse your baby.

Sudafed

Sudafed is a brand name for pseudoephedrine. Sudafed PE is a brand name for phenylephrine. These decongestants can dry up your milk supply.

Pseudoephedrine can also cause irritability in babies. Phenylephrine has not been studied in infants and should be avoided.

Alternative Cold Medicines and Remedies

In addition to OTC medications, some alternative remedies can help treat symptoms of common illnesses (like colds), such as:

• Congestion: A steamy shower or bath, saline-only (saltwater) nasal spray, and plenty of warm fluids can help ease congestion.

• Cough: Warm water with lemon and honey can ease the nursing parent's cough. Honey is not recommended for children younger than 12 months of age, but if the nursing parent has honey in warm water or tea, it's considered safe.

• Sore throat: Gargling with warm salt water is a safe way to ease a sore throat. Eating cold ice pops may also offer some relief for throat pain, as would warm soup.
  

You can always talk to your healthcare provider about other options for symptom relief.

Summary

Your options for cold medications are limited while breastfeeding. Some are safe in small doses and for a short period of time, but others can have side effects for both the breastfeeding parent and the baby.

OTC pain and fever reducers, non-drowsy antihistamines, nasal sprays, and OTC cough medicines are generally safe while breastfeeding.

Ingredients that cause drowsiness can make it unsafe for you to hold your baby to nurse. Avoid products that contain alcohol, diphenhydramine, doxylamine, codeine, or hydrocodone while nursing.

Other medications, like phenylephrine and pseudoephedrine, can hinder milk production and cause irritability or other side effects in babies. Avoid products sold under the brand names Benedryl, Sudafed, NyQuil, and DayQuil while breastfeeding.

Keeping hydrated, using a humidifier, and getting as much rest as possible can help you feel better without side effects for you or your child.

If you have any questions or concerns, talk to your healthcare provider, breastfeeding specialist, or your child's pediatrician.