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Safety of Over-The-Counter Medications and Breast Feeding

Posted Jan 18 2013 12:00am

Winter. The time of runny noses, coughs that tickle, congested airways, watery eyes and sneezing marathons. For most, treating these symptoms with a quick over-the-counter medication is a no-brainer. However, for breastfeeding moms not all of these medications are considered safe. Here is a quick run-down of what breastfeeding moms should know when they head to the pharmacy:

Are analgesic safe while breastfeeding? That really depends on which type of analgesia taken. In general, there are three basic ingredients found in OTC analgesia medications. They are aspirin, acetaminophen and non-steroidal-anti-inflammatory-drugs (NSAIDS).  Aspirin is not recommended to take, due to the fact that aspirin enters the breast milk and can cause adverse effects on the baby. On the other hand, in general NSAIDS such as ibuprofen, naproxen, and ketoprofen are considered safe for breast feeding. NSAIDS such as these do not linger in the mother’s body for long and are not found to be transferred to the breast milk. Both acetaminophen and ibuprofen are accepted by the American Academy of Pediatrics (APP) as safe analgesia choices when breastfeeding.

Cough, cold and allergy products
These products tend to be a combination of antihistamines, decongestants, expectorants, antitussives and pain relievers. Therefore when considering these types of products, it is important to consider the safety of each of the individual ingredients for breast feeding. It is a good idea to avoid combination, long acting or extra strength products. Most antihistamines are considered safe; however some such as clemastine have been reported to cause infant drowsiness. Decongestant pseudoephedrine is found to be the most compatible with breast feeding, according to the AAP, however it can cause a decrease in breast milk production. So moms, make sure you get your fluids while breast feeding and taking this product.

Throat spray and lozenges
These products usually have a combination of soothing agents, local anesthetics and antiseptics. In generally these products are not transmitted to breast milk, and are therefore compatible with breastfeeding. BUT why not just make your own non pharmacological treatment? A hot honey (soothing), lemon (natural antiseptic) and cinnamon (naturally anti-inflammatory) is a great treatment to soothe a sore throat and carries no risk for mom or baby!

Nasal sprays and nasal products
Oxymetazoline is the most common product found in nasal sprays. This drug has side effects for breast feeding mothers such as decreased milk supply and rebound congestion. Products such as xylometazoline and naphazoline should also be avoided as these pass easily to the breast milk. Recommended treatment is a sodium chloride preparation for nasal congestion as it does not carry any of the risks associated with the products listed above. Also steaming your head over a hot bowl of water with a towel tends to loosen any mucus and can cause some relief from nasal decongestion. Just make sure the waters not too hot, as not to scald your face.

If you are ever concerned about an OCT medication when breast feeding, ask your pharmacist/physician/lactation nurse for advice and they will point you in the right direction!
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