Can I continue to breastfeed my baby while taking my allergy medicine?
When spring arrives in many parts of the United States that means pollen allergies are in full swing. I am often asked if a mother who is breastfeeding can safely take allergy medicines. Pollen allergies are not only annoying but they can also be debilitating. The first step in allergy management is always avoidance of the substance causing the allergy. This is almost impossible with pollen allergies.
The question about taking medication when breastfeeding should always be given careful consideration, there isn’t one answer that fits all breastfeeding mothers. In general, breastfeeding mothers are well advised to take as few medications as possible. A mother who is being treated for several medical conditions, as well as allergies, should carefully review the benefits and risks of taking allergy medicine with their physician and pharmacist. This is especially true if the infant is premature or very young.
Several factors are taken into consideration when a decision is being made about any medication a breastfeeding mother might need to take. The properties of a drug, that can result in transfer of more of the drug into a mother’s milk include low molecular weight, low protein binding, and high lipid solubility. If a mother has a very high concentration of a drug in her blood stream, more of the drug can end up in her milk supply. The baby’s age, maturity and total daily milk consumption as well as frequency of feedings are also important. This is the information your health care providers will be considering and fortunately, there are very good reference books available that review the information about each drug and provide guidance. Medications and Mothers Milk by Thomas W. Hale, PhD is one of the best resources for health care providers on this topic. The National Institutes of Health also has an excellent drugs and lactation database called LactMed.
To get back to allergy medications specifically, antihistamines are one of the mainstays of treatment for allergy. Fortunately, most of the newer non-sedating antihistamines can be used by breastfeeding mothers. Consult with your doctor and pharmacist for the names of specific medications that have been reviewed and approved for this use. Decongestant medications are used for the nasal stuffiness associated with allergy. They generally pass into human milk in very low concentrations so can be taken, however, there is some antidotal evidence suggesting they may hinder milk supply. Intranasal corticosteroid medications, available by prescription, may be used safely because very little gets into the mother’s bloodstream and therefore very little would pass through to the baby.
The bottom line is that breastfeeding mothers who suffer with pollen allergies can safely be treated for those allergies and continue to breastfeed.