What cold medicine can I take while breastfeeding?

It’s not fun to be sick with a cold while you’re trying to keep up with the demands of a breastfeeding baby, but take heart: It’s easier to treat your symptoms with over-the-counter (OTC) medications while you’re breastfeeding than when you’re pregnant. 

“The field of medications you can take is way wider than it is in pregnancy,” says Leah Mello, MD, an OB-GYN at Austin Regional Clinic in Austin, Texas. “A lot of common cold medications are okay to take while breastfeeding.” 

That said, there are limitations when treating your cold symptoms while breastfeeding and some meds you should avoid completely. Here’s everything you need to know about taking cold medications when you’re breastfeeding, from what you should take and what you should skip to when and how to dose safely.

Can you take cold medicine while breastfeeding?

For the most part, it’s okay for nursing moms to take many common cold medications. Many of the individual ingredients you might reach for to alleviate your symptoms—like decongestants, cough suppressants, and pain relievers—are generally considered safe, and the ones that aren’t often have safer alternatives that provide the same kind of symptom relief. 

There are a couple of caveats, though: Many of these medications do pass into breast milk in small doses, and some of them have the potential to decrease milk supply, as well. Neither of these caveats mean you can’t take these medications while breastfeeding—but it does mean you need to be aware of the possible side effects and pay special attention to dosing instructions. If you are a breastfeeding parent, it is best to check with your primary care provider, OB-GYN, or lactation specialist before taking medications. Also, there is a free database, Lactmed, you can also use to look up medications. Read all labels for active ingredients, including vitamins, supplements, naturopathic, and homeopathic substances.

According to Dr. Mello, one of the best ways to choose breastfeeding-friendly cold medications and reduce side effects is to stick with single-symptom formulations instead of multi-symptom ones; for example, taking Sudafed and Robitussin separately if you have a cough and congestion, rather than Dayquil or Tylenol Cold.

“Every time you have a list of multiple ingredients, that increases the chance of taking an unsafe one or exposing mom and baby to [something that could cause side effects],” Dr. Mello warns.

In other words, focus on treating your individual symptoms—even if that means taking multiple kinds of compatible drugs—rather than preparations that aim to treat a half-dozen symptoms or more. It’s also easier to track possible side effects this way; if you think something you’re taking is decreasing your milk production or making your baby irritable, you can cut it out while continuing to take other medications to see if it’s really the cause.

Safe cold medicine while breastfeeding

In general, pseudoephedrine, dextromethorphan, NSAID pain relievers, acetaminophen, and second-generation allergy medications such as Zyrtec and Claritin are considered safe options for treating cold symptoms while breastfeeding. Per Dr. Mello, these drugs typically don’t pass through breast milk in high enough quantities to cause side effects in your baby.

She does advise breastfeeding moms to avoid first-generation allergy medications like Benadryl, however, as they can cause sedation in your baby.

It’s also important to pay attention to more than just the active ingredients. Other ingredients often included in common cold medications, especially cough syrups may be harmful. “Many preparations contain a combination of dextromethorphan and ethanol [i.e., alcohol], and those preparations should be avoided in breastfeeding,” says Hannah R. Fudin, Pharm.D., a clinical pharmacist with the U.S. Department of Veterans Affairs. 

Make sure to check the label of cough medications for alcohol before taking anything while breastfeeding; while many don’t include alcohol, there are still plenty of OTC medications, including cough syrups, that use it to increase the sedating effects of the medication.

How to take cold medicine safely

Even though many typical cold medications can be taken by breastfeeding women, it’s still important to be mindful of any possible interactions, contraindications, and side effects of OTC drugs. And really, that goes for everyone!

“You should always follow the dosing on the bottle, whether you’re pregnant or not,” Dr. Mello says. All drugs can cause side effects under the right circumstances. She adds that you should never take more than the recommended amount of a drug within the timeframe given on the packaging.

Even though taking single-symptom medication usually reduces the risk of complications for breastfeeding mothers, you also have to be careful when mixing and matching drugs; make sure there are no drug-to-drug interactions with other medications you’re taking, or that you don’t take two medications with the same ingredient. If you’re unsure, ask your pharmacist about drug interactions for the medications you want to take.

As far as the timing of your dosages, you may be able to orient them around your baby’s feeding schedule to further reduce the amount of medication that ends up in your breast milk—though this may not always be possible or even necessary, depending on the drug. The American Academy of Pediatrics says that short-acting medications are always preferable to long-acting ones. (For example, you should opt for a four- to six-hour preparation of pseudoephedrine versus a 12-hour extended-release formula if you have a choice.) It may be helpful to write down the names of medications, doses, and times taken.

Short-acting medications can be taken right after your baby feeds, allowing a good amount of the drug to leave your system before the next feeding. If this isn’t possible, the AAP recommends taking long-acting drugs when your baby goes down for their longest period of sleep.

Finally, it’s important to observe your baby for side effects if you’re breastfeeding while taking any medication. “Some medications can cause irritability and decreased milk supply, along with drowsiness, in babies [when mom is taking them],” Dr. Mello says.

Home remedies for a cold 

If you’re still concerned about taking any medications while breastfeeding—or you want to supplement OTC drugs with natural remedies—there are also non-pharmaceutical ways to ease your symptoms. Some of these cold remedies are safe to use while breastfeeding, and some may or may not be (i.e., the data is unclear); if you have concerns, check with your provider or lactation consultant. 

Definitely safe for breastfeeding:

• Saline rinses: Per the University of Michigan Health, rinsing your sinuses with saline can thin and dislodge mucus, relieving symptoms of congestion.
• Steam: Similar to saline rinses, steam can break up stubborn congestion in your sinuses (as well as your chest) and make it easier to breathe. You can sit in a steamy bathroom or use a humidifier to generate steam.
• Hydration: Chicken soup, hot tea, even plain old water: staying hydrated also helps keep mucus thin, which means it’s easier to get rid of, and warm beverages can soothe a sore throat.
• Honey: Speaking of soothing, honey is a safe and easy way to coat an irritated, scratchy throat and calm annoying coughs. 

Maybe safe for breastfeeding:

• Vitamin C: There’s a lot of debate over whether or not vitamin C helps anyone fight off colds, pregnant or not, but if you’re a C-devotee wondering if you can increase your dosage during an illness, you should check with your doctor. While normal amounts of vitamin C (like the daily recommended dose of 75 milligrams) seem to be fine, there’s not a lot of research about extra doses of vitamin C, like the kind you might take to boost your immune system when sick. According to LactMed, the Drugs and Lactation Database, high doses are probably fine—but it’s better to get the green light from your healthcare provider.

Whatever you choose, there is one thing you should definitely not do: Stop breastfeeding your baby out of fear of spreading germs through close contact. In fact, breastfeeding can protect your infant from illness.

“It’s okay to keep feeding your baby while you’re sick—your body is making antibodies for the virus, which get passed through your breast milk,” explains Dr. Mello. “So keep your baby’s feedings, but if you’re worried, wear a mask and add in some extra handwashing.”

If you’re unsure at all about the safety of any medication while breastfeeding, skip Google and give your provider or child’s pediatrician a call, Dr. Mello suggests; they’re much more likely to have accurate and up-to-date information about which drugs should and should not be taken if you’re breastfeeding.