Everything you need to know about managing a cold while pumping or nursing your baby. 

Whether you’re dealing with your first cold of the fall and winter season or just battling the daily germs that your baby brings home from daycare, you might be wondering which medications are safe to take if you’re still breastfeeding your baby. 

While it’s true that cold medications can pass through your bloodstream and into your breast milk (this is true of any drug!), this doesn’t necessarily mean that they’re off limits! Below, we’ll walk through: 

• How medications pass into your breast milk 
• Cold medicines that are safe to take 
• Cold medicines that should be used with caution
• Alternative options if you want to try and avoid medication 
• And more! 

General Guidelines for Taking Medication While Breastfeeding 

According to the CDC, most medications will pass through moms’ bloodstream and into their breast milk in small quantities — usually just 10% or less! The good news is that they will have little (if any) negative impact on milk supply or the health of your baby. (One exception to this rule? Decongestants and cough suppressants, which may cause your supply to dip due to the restriction of blood flow to the breasts. More on this later!)

That being said, you should always talk to your OBGYN, pediatrician, or other healthcare provider before taking anything that you’re unsure about. If possible, you can also try to take the medication immediately after pumping or breastfeeding, which might lower your baby’s exposure. 

Safe Cold Medicines for Breastfeeding Mothers

Acetaminophen 

Both during pregnancy and postpartum, acetaminophen (and its most popular brand, Tylenol) is a medication that is commonly recommended by doctors for fevers, headaches and other common cold symptoms. 

If you’ve given birth before, you may remember taking it after delivery to manage cramping, swelling, inflammation, and general discomfort. In fact, according to the NIH, studies show that taking acetaminophen (as well as ibuprofen) on a fixed schedule for the first 24 hours after a vaginal delivery can increase the rate of breastfeeding! 

While breastfeeding, note that you should not exceed a dosage of 4,000 mg per day. Anything more than that may pose the risk of damage to your liver. Additionally, you’ll want to limit alcohol consumption while taking acetaminophen — something you’re probably doing anyway if you’re pumping or nursing. 

Ibuprofen  

While moms are told to avoid ibuprofen (such as Motrin and Advil) while pregnant due to the fact that it can cause fetal kidney, heart, and lung, it is totally safe to take when breastfeeding — both for you and your baby. 

Like acetaminophen, only small amounts of ibuprofen will travel into the bloodstream, and its short half-life means that it will have no negative effects on your baby (or your supply). Just remember to stick to the recommended dosage of 1,200 mg per day. 

If you’re dealing with serious pain or discomfort, you might consider alternating between Tylenol and Motrin or Advil every three to four hours. Otherwise, you should wait the recommended duration of six hours before taking another dose of the same medication. (In other words, you should only take a dose of Motrin or Advil every six hours, and the same goes for a dose of Tylenol.)

Antihistamines (Loratadine, Cetirizine)

Antihistamines such as loratadine (aka Claritin) and cetirizine (aka Zyrtec) can be extremely helpful for mothers dealing with allergy symptoms like congestion, and are considered safe to use when breastfeeding. 

Note that other antihistamines, such as fexofenadine (also known as Allegra) are often considered safe as well. However, there is less research to support their usage, so you should speak with your healthcare provider if Claritin or Zyrtec aren’t doing the trick. They may provide an alternative in the form of nasal spray or eye drops, or suggest alternative remedies beyond medication. (More on this later!)

The issue with antihistamines is that when taken in large doses, they post a risk of drowsiness or sedation in babies. This can lead to difficulty feeding, especially in the early days when feeding often and gaining weight is critical. 

Cold Medicines to Avoid or Use With Caution

There are a few categories of medication that you’ll want to avoid due to their potential negative impacts on your milk supply and the health and wellbeing of your baby. 

Decongestants 

Decongestants such as pseudoephedrine and phenylephrine (both found in Sudafed), which can be used to treat sinus pain, pressure, and congestion, should be avoided while breastfeeding. Even though small amounts of this medication in breast milk are likely to be harmless, you can never be too careful when you’re dealing with a newborn! 

These medications may lead to irritability in your baby (the last thing you want when you’re sleep deprived!) and cause a decrease in your supply, especially if you're newly postpartum or already struggling with your production. Why? These medications are designed to dry up the mucus that’s causing your stuffy nose, and can end up drying up your milk as well. 

If you’ve accidentally taken this medication, reach out to your doctor and look out for symptoms of irritability, trouble sleeping, tremors, difficulty feeding, or trouble gaining weight in your baby. 

Cough Suppressants 

Found in medications like Robitussin that are designed to relieve the symptoms of dry cough, dextromethorphan is generally considered to be safe while breastfeeding. There are, however, a few things that you should do:

• Take the lowest dose for the shortest amount of time possible 
• Try to take this medication just before breastfeeding, since this will allow it to pass through your bloodstream before the next time that you pump or nurse
• Avoid if your cough is “chesty” or phlegm-y as opposed to dry, since suppressing a chesty cough could lead to infection 

While dextromethorphan is the safest of all the cough medications to take when breastfeeding, you’ll still want to be on the lookout for signs of drowsiness or difficulty feeding in your baby. 

Multi-Symptom Cold Medications

Multi-symptom medications, which include things like DayQuil and NyQuil, combine various medications to relieve more than just ailment. (Think: congestion and headache, fever and cough, etc.) 

These medications can be very effective when dealing with pain and discomfort, but should be avoided when breastfeeding if possible. This is because multiple ingredients mean more potential side effects! Additionally, multiple ingredients mean that it might be more difficult to identify the cause of negative reactions in mothers or babies if they occur. 

If you absolutely must take these medications, and have discussed your plan with your doctor, here are a few things to keep in mind: 

• Take the lowest dose for the shortest time possible, and take at the time of breastfeeding to give it time to move through your bloodstream before your next feed 
• Avoid anything labeled “extra strength,” as it will remain in the bloodstream for longer 
• Avoid night time medications with high alcohol content, as it may cause drowsiness 
• Avoid anything with the ingredient povidone-iodine, as it can raise iodine levels in breastmilk and potentially lead to hypothyroidism in babies

In other words: read your labels and look for alternatives whenever possible! 

Alternative Remedies for Cold Relief

While medication may sometimes be the only option for relief, there are a number of alternative remedies that may help alleviate cold symptoms. It can never hurt to incorporate these into your healing routine regardless of whether or not you’re taking something from the pharmacy! 

Hydration and Rest

When recovering from a cold, staying hydrated and getting plenty of rest should be high on your list of to-dos. Water will help moisten your nasal passages, loosen the mucus that causes congestion and coughs, maintain a healthy body temperature, and help your blood circulate more freely (essential when trying to fight off a virus). Clear soups and broths and drinks with electrolytes (like coconut water) are also great options. 

When you sleep more, you’re giving your immune system an opportunity to recharge, and helping your body produce critical cytokines, which are the proteins that help fight off inflammation and infection. 

Saline Nasal Sprays and Steam Inhalation

Saline sprays, rinses, and steam baths can be a great option if you’re trying to avoid taking a nasal decongestant. They are effective at moisturizing the nasal passage, loosening up mucus, washing away allergens, and reducing irritation to promote healing.   

Similar to hydration and rest, this is something you can add to your routine even if you’re taking cold medicine — the more you can do to support your body, the better! 

Honey and Herbal Teas

There are a number of reasons to incorporate honey into your healing routine if you’re dealing with a cough or cold. In addition to coating the throat, which can help reduce the urge to cough and soothe discomfort, it may also help reduce mucus secretion and reduce irritation and inflammation. You can mix it with lemon water or hot tea, or simply take it from a teaspoon. (Note that you should keep it away from your baby until they are 12 months old to reduce the risk of botulism, a rare but serious form of food poisoning that can be caused by naturally occurring bacteria in honey.)

You can also talk to your healthcare provider about drinking herbal tea, which can help coat your throat and support your immune system. Just keep in mind that certain herbs, such as ginseng and sage, are not safe to consume while breastfeeding due to their potential impact on milk production. 

Managing Cold Symptoms Safely While Breastfeeding

There’s no way around it: managing a cold while breastfeeding and caring for an infant can be draining. But with the right medication plan, you should be able to get some relief! 

You should always consult your doctor if you have questions about what’s safe to take while pumping or nursing. If you need to take medication that may pose risks, make sure to keep an eye on your supply and monitor your baby for any signs of drowsiness, difficulty feeding, or other side effects. And remember that you can always explore alternative remedies in place of (or in addition to) over-the-counter drugs. 

For more articles on maintaining your health and wellbeing while breastfeeding, check out our blog and YouTube channel for expert-backed guidance. 

FAQs

Can I take Tylenol while breastfeeding?

• Yes, Tylenol (acetaminophen) is generally considered safe for breastfeeding mothers. It’s often recommended for relieving pain and reducing fever. However, it’s always a good idea to follow the recommended dosage and consult your healthcare provider if you have any concerns.

Can you take DayQuil or NyQuil while breastfeeding?

• DayQuil and NyQuil contain multiple active ingredients, which can make it difficult to identify which medications are causing side effects in the event that they occur. In addition, ingredients in these medications can potentially reduce milk supply or affect your baby. It’s best to consult your healthcare provider before using multi-symptom cold medications like DayQuil or NyQuil. 

What cold medicine can I take while breastfeeding?

• Safe options for cold relief while breastfeeding include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and some antihistamines like loratadine and cetirizine. Decongestants, cough suppressants, and multi-symptom medications should be used with caution, and it’s important to consult your healthcare provider before taking any medication.

Are natural remedies safe for cold relief during breastfeeding?

• Many natural remedies, such as staying hydrated, using saline nasal sprays, and drinking certain herbal teas, are safe and effective for cold relief while breastfeeding. However, always consult your healthcare provider before using any herbal supplements or remedies.

What should I do if I notice side effects in my baby after taking cold medicine?

• If you observe any unusual symptoms in your baby (such as irritability, sleepiness, or feeding difficulties) after you’ve taken cold medicine, contact your pediatrician or a lactation consultant immediately. They can provide guidance on how to proceed and whether you should discontinue the medication.

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