Which cold remedies are safe while breastfeeding?

Alexander Kolb profile photo.
Reviewed by Dr. Alex Kolb, Pharm.D, R.Ph.Written by Neve Spicer Updated on July 23rd, 2021

On a good day, being sick can feel like a plain old bummer. When you are a mother, though, it’s darn near close to a disaster, and all you want is relief so that you can keep on parenting another day. So you reach into your medicine cabinet and study its contents when reality hits you.

You are not just a mom who has a cold.

You are a mom who has a cold and is breastfeeding.

But wait! You don’t need to slink away from that medicine cabinet and resign yourself to fevers and sniffles for the next week or two. While you might find your options for cold symptom relief are not as robust as they were pre-pregnancy, there are still plenty of cold remedies that breastfeeding mothers can take.

Before taking any medications

Check with your doctor:

  • Make sure you know what the active ingredient is
  • Check proper dosing levels
  • Be prepared to monitor your baby for any behavioral or medical changes

Cough medicine

Where there’s a cold, there is usually an associated cough. While it can be tempting to grab your go-to cough suppressant, when you are breastfeeding you have to be careful about what you are putting in your body.ou don’t want to share everything with your baby! Unfortunately, even ‘breastfeeding safe’ drugs carry some risks, and it is highly advisable that you speak to your doctor before starting any type of medication.

Pseudoephedrine – Thought to be mostly safe, this drug can pass into breast milk and to your nursing baby. There is evidence suggesting it will have little to no effect on your child, although irritability was noted in some babies who had ingested pseudoephedrine. While helpful, this drug can affect your milk supply, so mothers who are experiencing lactation issues might want to avoid it altogether.

Dextromethorphan – Although considered one of the safer pharmaceutical options for managing a cough, there is still the possibility that this drug can transfer to your breast milk and thus to your baby. You will have to keep an eye on him/her for any unusual drowsiness or a decrease in appetite while you are on this drug.1Over-The-Counter Treatments for Cough and Cold infantrisk.com/content/over-counter-treatments-cough-and-cold

Benzonatate – Unfortunately, there is not enough research on this drug for anyone to cast a yea or nay vote on whether or not it is safe for breastfeeding moms. With that being said, rather be safe than sorry.2Differences in Organic, Natural, and Health Foods healthychildren.org/English/healthy-living/nutrition/Pages/Differences-in-Organic-Natural-and-Health-Foods.aspx

Codeine – This is a no-no for breastfeeding moms. The body converts codeine to morphine and, in some individuals, this happens very quickly. These people are called “ultra-rapid metabolizers of codeine” and if you happen to be one, your baby could actually overdose on morphine after breastfeeding.3Cough And Cold Combinations (Oral Route)Print

Related: 5 Go-To Recipes for Breastfeeding Moms

Pain and fever medications

If you are sick, you are probably feeling a few aches and pains, and might even run a fever. The good news is that you do have some options for relief.

Acetaminophen (e.g. Tylenol) This is safe for breastfeeding mothers because, while it can pass to your milk, it does so in very low levels. You can take up to the maximum recommended daily dosage without harming your baby.Kanabar, D., Dale, S., & Rawat, M. (2007). A review of ibuprofen and acetaminophen use in febrile children and the occurrence of asthma-related symptoms. Clinical therapeutics, 29(12), 2716-2723. healthline.com

Ibuprofen (e.g. Advil, Proprinal, Motrin) – Also considered safe due to its low breastmilk transference rate, you can take the maximum daily dosage to find relief from your discomfort.4Kanabar, D., Dale, S., & Rawat, M. (2007). A review of ibuprofen and acetaminophen use in febrile children and the occurrence of asthma-related symptoms. Clinical therapeutics, 29(12), 2716-2723.

Asprin – Sorry, but this go-to is a no-go for breastfeeding mothers. There is a distinct possibility, as proven through several studies, that the use of aspirin is linked to the development of Reye’s syndrome in children. Reye’s syndrome can lead to swelling in the brain and liver damage, so it is not something you want to risk.5Aspirin and Breastfeeding

Nasal sprays

While not always fun to administer, nasal sprays can be a miracle when you are having some serious nasal congestion issues. It is important to remember that nasal sprays are recommended as short-term remedies only. Using them for over three days puts you at risk for the ‘rebound effect’, which can, among other things, actually make your congestion worse.6Can You Overuse Nasal Spray? www.webmd.com/allergies/features/nasal-spray-are-you-overdoing-it#1

Xylometazoline (e.g. Otrivine) – While it is unknown if this drug passes into breast milk, there have been no recorded incidents of it causing harm in breastfeeding mothers or their children. However, rather be safe than sorry.7Castellano, F., & Mautone, G. (2002). Decongestant activity of a new formulation of xylometazoline nasal spray: a double-blind, randomized versus placebo and reference drugs controlled, dose-effect study. Drugs under experimental and clinical research, 28(1), 27-35. drugs.com

Oxymetazoline (e.g. Afrin) – Studies are virtually non-existent as to what effect oxymetazoline has on breastfeeding mothers. As such, we recommend talking to your doctor before using and only pursuing it as a last resort for relief.8Oxymetazoline use while Breastfeeding

Related: How to Dry up Your Breast Milk Quickly and Naturally

Home remedies for cold relief

While the odds are good that you have spent the better part of your life taking cough syrup to relieve cold symptoms, it is understandable that now, as a breastfeeding mother, you might want to try some non-pharmaceutical options.

Editor’s Note:

Nonpharmacologic treatments, like catching up on sleep or a saline rinse, should be considered before trying medications. Because during breastfeeding, keeping it simple may be the best medicine!

Gargling with salt water – This one isn’t just an old wives’ tale; it has science backing it up. Water is attracted to salt so when you gargle, you are effectively pulling fluid from the surrounding tissue and, with that fluid, you are washing some of that nasty virus out. It will not cure your cold, unfortunately, but it will help soothe your throat. To give this method a go, try mixing 1/4 – 1/2 teaspoon of salt into 8 ounces of warm water.912 Natural Treatment Tips for Colds and Flu webmd.com/cold-and-flu/12-tips-prevent-colds-flu-1#1

Editor’s Note:

When performing a nasal cleanse (like with a Neti Pot), it is important to use distilled water and NOT tap water. Tap water may contain discrete amounts of organisms and minerals that can do damage to your nasal and sinus canals.

Salt water and baking soda nose flush – Why use salt water only as a gargle? By mixing 1/4 teaspoon of baking soda and 1/4 teaspoon of salt into 8 ounces of warm water, you will create a liquid that can remove some viral and bacterial particles from your nasal passages while breaking up the mucus that causes congestion. To flush your nasal passages, use a nasal irrigation kit (like a Neti Pot) or a good old-fashioned bulb syringe. Plug one nostril, administering the flush through the unplugged nostril, and repeat up to three times before switching sides.1012 Natural Treatment Tips for Colds and Fluwebmd.com/cold-and-flu/12-tips-prevent-colds-flu-1#1

Steamy Shower – Okay, so I can’t exactly point you to a study that says, in no uncertain terms, that steam helps clear up congestOkay, so I can’t exactly point you to a study that says, in no uncertain terms, that steam helps clear up congestion and is a miracle cure for a cough. I can tell you, however, that many mothers before us have passed down the sage advice of standing in a hot shower when you are feeling unwell. I can also tell you that it is pretty great to have an excuse to stand in the shower for an extra ten minutes. Hey, if nothing else it will relax you and moisturize your nasal passages.118 Tips to Treat Colds and Flu the ‘Natural’ Way

Rest, rest, rest – I know, I might as well have just told you to fly into space and bring home a sack of moon rocks. But seriously, your body is fighting the good fight and trying to get you well ASAP. If at all possible, have a relative or friend pop over to watch the little one while you catch a little extra sleep. If you’re not adverse to a bottle, pump some breastmilk and let your partner take care of the PM feedings for a few days. Do all you can to catch some extra ZZZs.

Related: Does Breastmilk Stain? (Yep! and Here’s how to Remove It)

Vitamins and minerals

It’s great to try and use things that are on the natural side to speed along your recovery, but remember that just because something is called a vitamin or mineral doesn’t mean it is safe for breastfeeding mothers or that it won’t impact your baby. Consult your doctor or lactation counselor before adding a mineral or vitamin to your daily routine.

Vitamin C – Who doesn’t want to chug orange juice when they’re feeling ill? A little extra vitamin C when you are nursing is fine, but don’t overdo it; taking too much vitamin C can result in headaches, vomiting, or even kidney stones. The upper tolerance level is generally considered to be about 2,000 milligrams for women over 18 and 1,800 milligrams for those under 18.12Vitamin C for the Common Cold webmd.com/cold-and-flu/cold-guide/vitamin-c-for-common-cold#1

Zinc Gluconate – This mineral has long been thought to shorten or prevent illness, but the science remains inconclusive. Often found in lozenges or nasal sprays, it is considered safe for breastfeeding mothers in doses up to 50 milligrams.13Zinc for colds: The final word?

Herbal Remedies – While herbal remedies can be great, they are not always the appropriate answer for breastfeeding mothers. Some herbs can affect your milk supply or even put you or your child at risk for an overdose if taken in too high a dose or too often.

Discuss all herbal remedies with your doctor or lactation consultant.14Natural Cold Remedies While Breastfeeding

Wrapping up

Just because you are a breastfeeding mother does not mean that you are stuck suffering with no relief from your cold. Between salt water flushes, steam, and good old-fashioned rest, you can still feel better without medication. And if you do need medication, odds are good that you will find something that is safe for you and your child. Whether it is a good old cough syrup or a nasal spray, just be sure to consult with a doctor or lactation specialist to be sure what you are taking is safe for you and your baby as individuals.

Remember, there is no shame in getting sick and no shame in needing help with your baby. The act of being a mother makes us superheroes in many ways, but unfortunately, being impervious to germs is not one.

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Alexander Kolb profile photo.
Reviewed by Dr. Alex Kolb, Pharm.D, R.Ph.Written by Neve Spicer Updated on July 23rd, 2021

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