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Safe Cold Flu Medications during Pregnancy & Breast Feeding

Safe Cold Flu Medications during Pregnancy & Breast Feeding

Breastfeeding mothers wonder whether some quick relief from over-the-counter medications could negatively impact their breastfeeding baby. When it comes to your baby no loss can be afforded if it poses even a negligible risk and therefore while taking medications for common cold flu, pregnant women are to follow special instructions. Research shows that some cold and flu medications are better than others when it comes to breastfeeding.
Here are some cold flu medications that are safe while breastfeeding.
The common active ingredients in cold and flu syrups are Dextromethorphan, acetaminophen, and doxylamine succinate along with their generic ingredients.

Dextromethorphan is a cough suppressant commonly used for treating colds in children and adults. It is generally considered safe while breastfeeding.
Acetaminophen, a drug used to treat pain and reduce fever in adults and children, works for pregnant women as well.
A common active ingredient in the nighttime formulations is doxylamine succinate, an antihistamine that causes sedation in its users and can be used for nausea and vomiting in pregnancy. This drug is considered safe while breastfeeding yet extensive study is going on.

Another fever reducer and pain medication naming Ibuprofen often used during a cold, also safe for infants of breastfeeding mothers. Even high maternal consumption of ibuprofen leads to very little excretion in breast milk.
Phenylephrine is most commonly used as a nasal decongestant in adults and children. It is generally considered safe while breastfeeding unless there has been high maternal consumption of the drug, and can cause tachycardia and hypertension in sensitive individuals as phenylephrine has poor oral bioavailability.
Pseudoephedrine, a nasal decongestant commonly used to treat colds, has shown to be secreted in breast milk in extremely low levels and is considered safe while breastfeeding.
During the cold and flu season, nasal sprays are additionally used. These include fluticasone and oxymetazoline (Afrin). Fluticasone is a steroid that is of intranasal use for congested noses and additionally for asthma. When using the medication as indicated, maternal plasma levels are undetectable. Thus, it is unlikely that a significant amount of this drug would pass into breastmilk to affect a breastfeeding infant. Oxymetazoline is another intranasal decongestant used quite frequently for runny noses. Due to the local effect of this drug, it is unlikely that significant levels of this drug would be transferred to a breastfeeding infant and is preferred over oral decongestants during breastfeeding. Oxymetazoline use should be limited to 3 days to avoid rebound congestion.
Vitamin C intake is effective for cold-fighting. Although its efficacy is still in research, it is likely not harmful to supplement while breastfeeding. Even high levels of maternal consumption resulted in only slightly increased levels in breastmilk.

Safe Cold Flu Medications during Pregnancy & Breast Feeding

Here is a table to classify the safety level of the medications as per data collected:-

Medication Breastfeeding Class Description
Acetaminophen L1 Extensive data. Compatible.
Dextromethorphan L1 Extensive data. Compatible.
Ibuprofen L1 Extensive data. Compatible.
Vitamin C L1 Limited data. Probably compatible.
Diphenhydramine L2 Limited data. Probably compatible.
Zinc Oxide L2 Limited data. Probably compatible.*
Zinc Salts L2 Limited data. Probably compatible.*
Doxylamine                                   L3 No data. Probably compatible.
Fluticasone L3 No data. Probably compatible.
Guaifenesin L3 No data. Probably compatible.
Ozymetazoline L3 No Data. Probably compatible.
Phenylephrine L3 No data. Probably compatible.
Pseudoephedrine L3 Limited data. Probably compatible
*Avoid early postnatal use when milk levels of zinc are high.

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