What allergy medicine can i take while breastfeeding

Breast milk contains five antibodies: Immunoglobulins A, D, G, M, and the aforementioned IgE. Each serves its own function to assist the body stay healthy and avoid allergies.

While more research is still needed, some evidence suggests that passing these antibodies to a baby via breast milk may assist reduce or prevent some types of allergies (particularly in babies with a family history), although it may own no significant effect on others.

What Antibodies in Breast Milk Do


Can Allergens Be Passed Through Breast Milk?

It is rare for a breastfeeding kid to experience an allergic response to something passed through a mother’s milk.

The most likely suspect, when this does happen, is a response to cow’s milk in a mother’s diet.

While only trace amounts of proteins from cow’s milk are passed to the kid through breast milk, in rare cases, it may trigger an allergic response in the breastfeeding child.

  1. Hives
  2. Poor sleep patterns
  3. Extreme paleness
  4. Chronic diarrhea
  5. Vomiting
  6. Unwillingness to feed
  7. Colic
  8. Acute diaper rash
  9. Eczema
  10. Incessant crying
  11. Colitis

A cow's milk allergy developing from exposure through a mother's breast milk is relatively rare, however, occurring in less than 1 percent of breastfed babies. If your kid does experience any of the above symptoms, contact your doctor correct away.

This section covers OTC drugs used for pain relief, cough and freezing, allergies, and sleep aids.

A typical pharmacy has shelf after shelf of medicines that can be sold without a doctor’s prescription.

These are called over-the-counter (OTC) drugs. Numerous concerned mothers wonder about the safety of these medications while they are breastfeeding a baby. While there are numerous brands and varieties of drugs on the market, there is a relatively little list of athletic ingredients in every those products. Careful review of the product label is an essential part of responsible and safe use of these medicines. Some preparations own more than one athletic ingredient.

(For other ailments, see our sections on acne and GI complaints.)

Analgesic and Antipyretics

Ibuprofen: The transfer of ibuprofen in breastmilk is well studied.

Extremely little of this medication makes it into the milk (about % of the mother’s dose). In addition, this drug is given directly to babies at much higher doses than this. Ibuprofen is the preferred analgesic in breastfeeding mothers. Do not exceed grams/day. Common Trade Names: Advil, Nuprin, Motrin.

Acetaminophen: Acetaminophen is compatible with breastfeeding as only little amounts are secreted into breastmilk. This is given directly to infants in doses much greater than they would get incidentally through the breastmilk. Acetaminophen is commonly included in combination products.

Do not exceed 4 grams/day. Common Trade Name: Tylenol.

Naproxen: Naproxen is less well studied than the other drugs in the same class. It is secreted into the breastmilk, but apparently not in quantities that would harm an baby. However, naproxen takes longer to be eliminated from the body than the other NSAIDs and has a greater potential to damage an infant’s cardiovascular system, kidneys, and gastrointestinal tract in the event of an overdose.

Short-term use (<2 weeks) of naproxen postpartum, or infrequent or occasional use should be compatible with breastfeeding. Do not exceed 1 gram/day. Common trade names: Naprox, Naprosyn, Aleve.

Aspirin: Although aspirin is secreted into breastmilk in little quantities, it has the potential to cause bleeding problems in infants and increases the risk of Reye syndrome (liver damage associated with using aspirin to treat certain viral illnesses in children).

The use of “baby aspirin (81 mg per day)” is unlikely to increase the risk of these problems. Aspirin should not be the first choice for pain relief in breastfeeding mothers.

What allergy medicine can i take while breastfeeding

However, the benefits of its unique pharmacology may outweigh the risks for women with certain conditions love rheumatic fever and after heart attacks. The decision to use aspirin should be undertaken with physician guidance. Common trade name: Bayer.

*Some headache medicines, love Excedrin, contain caffeine. See our discussion of caffeine for more information.

Cough, chest congestion

Guaifenesin:  This is an expectorant used to loosen respiratory tract secretions.

It does not suppress cough. The poor efficacy of expectorants in general would propose that they do not provide enough justification for use in breastfeeding mothers. However, untoward effects to the infants own not been described.

What allergy medicine can i take while breastfeeding

Common trade names: Robitussin, Mucinex

Dextromethorphan: 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.

Allergies and sinus congestion

Diphenhydramine:  Diphenhydramine is an antihistamine that is often used in cough, freezing, sinus, and allergy formulations. It is also the main component in numerous sleep aids, including “nighttime” versions of freezing medications, as well as motion sickness pills.

Although the levels are low in breastmilk, this medication can cause sedation in both mom and baby and therefore is not ideal in breastfeeding mothers. There are numerous non-sedating antihistamines on the market, which are likely a better choice.

What allergy medicine can i take while breastfeeding

These include cetirizine (Zyrtec), loratidine (Claritin), and fexofenadine (Allegra). There is some anecdotal evidence that diphenhydramine can suppress milk production, but this pattern is not supported by the medical literature. Common trade names: Benadryl, Tylenol PM.

Chlorpheniramine and Brompheniramine: These medicines are similar to diphenhydramine, but they own fewer studies about breastmilk safety. They are heavily sedating and not recommended. The non-sedating antihistamines are still better choices.

What allergy medicine can i take while breastfeeding

Common trade names: Aller-Chlor, C.P.M., Chlor-Phen, Chlor-Trimeton Allergy, Teldrin HBP.

Pseudoephedrine: Pseudoephedrine is an adrenergic compound used as a nasal decongestant. It does not own antihistamine properties. It is excreted into breastmilk in low levels. Caution should be used with this product as it may reduce milk production in some mothers in tardy stage lactation (mothers breastfeeding infants >8 months old).

Pseudoephedrine commonly appears in combination products. Common trade names: Sudafed, Claritin-D.

Phenylephrine: Phenylephrine is a decongestant that is commonly added to freezing mixtures and nasal sprays for use in colds, flu, and congestion. Levels in milk own not been reported, but experiments own shown that it has poor oral absorption in infants. Common trade names: Neofrin, Neosynephrine, Vicks Sinex Nasal.

Sleeping pills

Doxylamine: This is another sedating antihistamine, similar to diphenhydramine, which is more commonly used for its sedative properties.

There are no excellent studies about how much of this drug gets into breastmilk. In infants exposed to doxylamine, there are reports of sedation, apnea, and paradoxical CNS stimulation. Use caution with this medication. Common trade name: Unisom

Melatonin: Melatonin is a normal hormone secreted by the pineal gland in the human brain, mostly at night. It may either induce a sleep-like pattern in humans, or be the result of sleep; the evidence is not clear. It is definitely passed into human milk and some experts believe it is responsible for entraining the newborn brain to reset its circadian clock to that of the mom by communicating the time of day to the newborn.

The effect of orally istered melatonin on newborns is unknown, but no adverse reactions own been reported so far.

Nasal sprays

Oxymetazoline: This decongestant comes in several formulations that final between 4 and 12 hours. There are no excellent studies of oxymetazoline safety during breastfeeding, however, extremely little of it is expected to reach the milk because it is locally istered and poorly absorbed. For this reason, oxymetazoline is a probably a better choice than oral systemic decongestants such as pseudoephedrine during breastfeeding. Oxymetazoline should only be used briefly, no more than 3 days, to avoid rebound congestion. Common trade name: Afrin.

Triamcinolone: This is the first OTC steroid nasal spray to be marketed in the United States.

What allergy medicine can i take while breastfeeding

Triamcinolone may be used for longer periods of time without causing rebound congestion. There is virtually no risk to a breastfeeding baby when the mom uses this product nasally. Oral and topical forms (by prescription only) deserve more caution in their use. Common trade name: Nasacort.1

Nasal Saline Irrigation: Using salt water to irrigate the nose and sinuses is a practice dating back thousands of years. In modern pharmacies, saline is available in nasal sprays and nasal rinses, as well as mineral packets for home reconstitution.

Sinus rinsing (aka nasal lavage) is performed using a squeeze bulb or neti pot. This practice works by mechanically removing allergens, mucous, and microorganisms from the mucosal surface.

What allergy medicine can i take while breastfeeding

Studies own shown sinus and nasal rinsing to be highly effective in relieving symptoms of chronic rhinosinusitisand of limited utility in treating acute allergic problems or upper respiratory tract infections.Saline irrigation is the safest possible treatment for rhinosinusitis in pregnant or breastfeeding mothers. There is no drug or pathogen exposure to the baby. However, it is not advisable to act out saline irrigation directly on a baby because of the risk of aspiration. Bulb suction is the preferred method of relieving baby nasal congestion.

James Abbey, MD

InfantRisk Center

Image by Benjamin Miller

References:

1.         Hale TW.

Medications and mothers’ milk . Sixteenth ed. Amarillo, TX: Hale Pub., L.P.;

2.         Achilles N, Mosges R. Nasal saline irrigations for the symptoms of acute and chronic rhinosinusitis. Current allergy and asthma reports. Apr ;13(2)

3.         Kassel JC, King D, Spurling GK. Saline nasal irrigation for acute upper respiratory tract infections. The Cochrane database of systematic reviews. (3):CD


Allergies in Children

Babies and children can experience the finish range of allergic conditions, such as allergic rhinitis (hay fever), skin allergies (most common in kids 0 to 4), food allergies, eczema, asthma, and more.

Allergic reactions can be the result of immunologic changes in immunoglobulin E (IgE), an antibody formed by the immune system.

They can also be non-IgE mediated, instead involving mast cells and basophils. Babies may come into the world predisposed to allergies, but they may not actually own reactions until they've had repeated exposure to an allergen. In some cases, an allergy might not become obvious until later in life.


What the Research Shows

Allergy studies are challenging to execute on account of numerous factors — food introduction, genetic factors, and maternal diet being the most significant. But most studies authenticate that exclusive breastfeeding (even as little as one month) can lessen how often some allergies occur.

Evidence also suggests that exclusive breastfeeding during the first four months may offer protection against certain types of allergic diseases including cow's milk allergy and atopic dermatitis.

Other notable findings suggest:

  1. Breastfeeding may not reduce the risk of asthma. In a large-scale study published in the Journal of Allergy and Clinical Immunology, researchers looked at data from over , British adults. Based on self-reported information, the results suggested that breastfeeding as a kid did not frolic a role in preventing asthma and hay fever later in life.
  2. Breastfeeding may "boost" a baby's immune response. In one mouse study, for example, researchers found that a mother's milk contains complexes of food proteins that are then combined with her antibodies. This combination is then passed to the breastfeeding baby through breast milk.

    The infant's immune system then takes up these protein-antibody complexes, which triggers the baby's immune system to produce cells that assist protect against allergic reactions. A similar process may also take put in human mothers and children, although further research is needed.

  3. Breastfed infants may be less likely to develop eczema. Exclusive breastfeeding or breastfeeding and supplementing with a hydrolyzed baby formula has been shown to reduce the risk of eczema.
  4. Avoidance diets do not prevent allergies. In the past, breastfeeding women were sometimes cautioned to avoid consuming foods that were commonly associated with food allergies including peanuts, eggs, milk, soy, wheat, nuts, and shellfish.

    More recent research has shown no association between maternal exclusion diets and the prevention of allergies.

Position of the American Academy of Pediatrics

"The AAP recommends exclusive breastfeeding for about six months, with continuation of breastfeeding for one year or longer as mutually desired by mom and infant." Standard cow's milk-based formula is a first-choice alternative.


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