Coming down with a cold is miserable. Doing it while responsible for feeding a tiny human with your own body? That is a unique level of exhaustion.
When you are nursing, you think twice about everything you ingest. You naturally worry that the medication you take to feel better might pass through your milk and harm your baby.
We understand that anxiety. We wrote this guide to help you manage your symptoms without the stress. We will cover safe over-the-counter options, medications to avoid, and natural remedies to get you back on your feet.
Key Takeaways
- Pain Relief: Acetaminophen (Tylenol) and Ibuprofen (Advil) are generally considered safe for breastfeeding moms.
- Watch Your Supply: Decongestants containing pseudoephedrine can significantly decrease milk production.
- Natural Options: Hydration, honey, saline rinses, and humidifiers are effective ways to soothe symptoms naturally.
- Consultation: Always check with your doctor or a lactation consultant before starting a new medication.
Can I Take Medication While Breastfeeding?
You might instinctively say “no” to the medicine cabinet. After all, pregnancy came with a long list of forbidden substances. However, the rules for breastfeeding are quite different from pregnancy.
When you are pregnant, you share a direct blood supply with your baby through the placenta. While the placenta filters some germs, chemicals from medication pass through it easily.
Breastfeeding is different. There is a barrier between your blood and your milk. While some drugs can cross into breast milk, the amount is usually very low (1). Often, the concentration is so diluted that it poses no risk to your baby.
Take Note
Which Cold Medication Is Safe During Breastfeeding?
When you are standing in the pharmacy aisle, the choices can be overwhelming. Here is a breakdown of common cold medications and their safety profiles for nursing parents.
Acetaminophen
Acetaminophen is the active ingredient in Tylenol. It acts as a pain reliever and fever reducer. It does pass into breast milk, but only in small amounts. It is widely considered safe for breastfeeding mothers and is often the first choice for aches and fevers.
Ibuprofen
Ibuprofen is an anti-inflammatory drug found in Advil and Motrin. It helps with body aches and fevers. Research shows that very little ibuprofen transfers into breast milk, making it a safe option for your infant (2).
Antihistamines
Antihistamines combat runny noses and sneezing. They are generally considered safe, but the type you choose matters.
Opt for non-sedating antihistamines like loratadine (Claritin) or cetirizine (Zyrtec). Sedating antihistamines, like diphenhydramine (Benadryl), can make you drowsy. They might also make your baby sleepy or irritable.
Supply Warning
Decongestants
This category requires extra attention. Decongestants help clear a stuffy nose, but they come with a catch for breastfeeding moms.
- Pseudoephedrine: This is the active ingredient in Sudafed. While it is likely safe for the baby, it is known to decrease milk production significantly (3). One study showed a 24 percent drop in milk production after a single dose. Avoid this if your supply is low or just established.
- Phenylephrine: This is often used as an alternative in oral cold meds. It has poor oral absorption, meaning little gets into your system or milk. However, it is also less effective at clearing congestion.
Nasal Sprays
If you are congested, a nasal spray might be your best friend. Sprays like oxymetazoline (Afrin) or fluticasone (Flonase) are applied locally in the nose. Because they are not swallowed in large amounts, very little medication enters your bloodstream or milk. They are generally considered a safe, effective alternative to oral decongestants.
Cough Suppressants
A hacking cough keeps you and the baby awake. If you need a suppressant, read the labels carefully.
- Dextromethorphan: This is common in many OTC cough syrups (like Robitussin). It is generally considered compatible with breastfeeding, but use it with caution and watch your baby for any signs of drowsiness (4).
- Codeine: Avoid this. Some women metabolize codeine rapidly, turning it into morphine. This can lead to dangerous levels of morphine in breast milk, which can cause severe breathing problems in infants (5).
- Benzonatate: There is limited data on this prescription medication. Doctors usually recommend avoiding it unless absolutely necessary (6).
Combination Drugs (DayQuil/NyQuil)
Multi-symptom relief drugs are convenient, but they force you to take multiple active ingredients at once.
For example, many “nighttime” versions contain alcohol and sedating antihistamines, which you should generally avoid. “Daytime” versions often contain pseudoephedrine, which kills milk supply. It is safer to treat only the specific symptoms you have with single-ingredient medications.
Natural Cold Remedies When Breastfeeding
If you prefer to skip the pharmacy or just want to boost your recovery, natural remedies are powerful tools. They can soothe your symptoms without any risk to your milk.
1. Honey
Honey is a fantastic natural cough suppressant. It coats the throat and eases irritation. You can take a spoonful directly or mix it into warm tea.
Note: While safe for you, never give honey directly to a baby under one year old due to the risk of botulism. The botulism spores do not pass through breast milk, so it is safe for you to eat.
2. Rest
Your body heals when you sleep. This is easier said than done with a baby, but it is vital. Your immune system needs energy to fight the virus.
Try to nap when the baby naps. If possible, ask a partner or family member to handle diaper changes and soothing so you can stay in bed.
3. Humidifier
Dry air makes a sore throat and stuffy nose feel worse. A humidifier adds moisture to the room, soothing irritated tissues.
Doctors recommend cool mist humidifiers for safety. Steam vaporizers can cause burns if tipped over (7).
Keep It Clean
4. Zinc
Zinc is a mineral that helps support the immune system. Taking zinc gluconate lozenges within 24 hours of feeling sick may shorten your cold by a day (8). It is considered safe for breastfeeding.
5. Neti Pot
A neti pot uses a saline solution to flush out your nasal passages. It sounds intimidating, but it is highly effective for clearing congestion. Since it is just salt water, there are no chemicals to worry about.
Always use distilled or boiled (and cooled) water. Never use tap water, as it can contain organisms that are dangerous when flushed through the nose.
6. Hydration
Fevers and mucus production deplete your fluids. You need to stay hydrated to help your body function and to maintain your milk supply.
Aim for about three liters of fluid a day. Water is best, but you can mix it up with:
- Herbal teas (check ingredients for safety).
- Warm broth or soup.
- Coconut water.
- Fruit juice diluted with water.
FAQs
Can a Cold Decrease Milk Supply?
Yes, illness can cause a temporary dip in supply. This is usually due to dehydration, fatigue, or stress on your body rather than the virus itself. Some medications, specifically decongestants containing pseudoephedrine, can also dry up milk. Keep nursing frequently and drink plenty of water to protect your supply.
How Long Is a Cold Contagious to a Newborn?
Colds are generally contagious from a few days before symptoms start until about a week after. You are most contagious when your symptoms are at their peak. Continue breastfeeding, as your milk provides antibodies that help protect your baby from the very virus you are fighting.
How Can I Prevent Passing My Cold to My Baby?
Wash your hands constantly, especially before handling the baby or breastfeeding. Avoid sneezing or coughing directly on the baby. While it might seem counterintuitive, keep breastfeeding. The specific antibodies your body creates to fight the cold are passed to the baby, giving them passive immunity.
Does Fresh Air Help With a Cold?
Yes, fresh air can help clear nasal passages and improve your mood. Being cooped up inside with stale air can sometimes make congestion feel worse. Just bundle up appropriately so you do not lower your body temperature, which could stress your immune system.
Can I Take Vitamin C While Breastfeeding?
Yes, Vitamin C is safe to take while breastfeeding. It is a water-soluble vitamin, so your body will flush out what it does not need. Many moms take it to give their immune system a boost. Just stick to the recommended daily limits to avoid stomach upset.
Should I “Pump and Dump” After Taking Cold Medicine?
In most cases, you do not need to pump and dump for standard over-the-counter cold medications like Tylenol or Ibuprofen. If you have taken a medication that is not recommended for breastfeeding, consult your doctor. They can tell you how long the drug stays in your system so you can time your feeds safely.
The Final Word On Cold Medications
Battling a cold is never fun, but it is even harder when you are the primary food source for a little one.
The good news is that you do not have to suffer in silence. Pain relievers like Tylenol and Ibuprofen are generally safe, and natural remedies like saline rinses and hydration can work wonders. Just keep an eye out for decongestants that might sabotage your milk supply.
Listen to your body, rest when you can, and do not hesitate to call your doctor if you are unsure about a specific label. You will be back to feeling like yourself soon.
It’s normal to experience a dip in your milk supply during a maternal illness. Once you’re feeling better, nurse more often or add some pumping to your routine for a few days. If you’re having trouble getting your supply back, seek the help of a lactation consultant.
Editor's Note:
Michelle Roth, BA, IBCLC
