Taking Cold Medicine While Breastfeeding: Is It Safe?

If you’re a nursing mom with a cold, you’ve probably wondered whether it’s safe for you to take cold medication. The good news is that there are several over-the-counter (OTC) cold medicines you can take while breastfeeding without putting your baby at risk.

But what cold medicine is safe to take while breastfeeding, and what about natural remedies? Let’s review the answers to these questions and more.

Do cold medications pass into breast milk?

It’s possible. Just as your child can get nutrients from your breast milk, they may be exposed to medications in your breast milk as well.

When it comes to cold medications, most only enter your breastmilk in small amounts, so they won’t affect your baby. But others may have side effects for your baby or affect your milk supply. We’ll talk about these later.

What cold medicines are safe to take while breastfeeding?

Here’s a list of OTC cold medications by symptom that are generally considered safe to take while breastfeeding. But always check with your healthcare team before taking any medication while breastfeeding. They can help you figure out if it’s safe to take.

Keep in mind that many OTC cold products contain several ingredients. But are products like DayQuil Cold and Flu, Tylenol Severe Cold and Flu, or other combination cold medications safe to take while breastfeeding?

The best way to be sure is to check the “Drug Facts” box for the list of ingredients. If each ingredient is safe to take while breastfeeding, the combination product is too. Just be sure to avoid duplicate ingredients if you take more than one medication for your cold symptoms.

Headache, fever, or sore throat

The following OTC medications are considered safe to take while breastfeeding and are the first-choice options for a headache, fever, or sore throat:

• Ibuprofen (Advil, Motrin)

• Acetaminophen (Tylenol)

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Other OTC medications are also considered safe to take. But there are some things to consider before you take them. These include naproxen (Aleve) and aspirin (Ecotrin, Bayer Aspirin).

Naproxen stays in the breast milk longer than other pain medications. This may increase the risk for side effects in your infant, such as bleeding or vomiting. So even though it’s likely safe to take short term, it’s not considered the best option when breastfeeding.

Low-dose aspirin (75 mg to 300 mg daily) is likely safe to take while breastfeeding. But higher doses can build up in your baby’s system over time and increase the risk of serious side effects, including bleeding and Reye’s syndrome. In general, low-dose aspirin is only recommended while breastfeeding if a healthcare professional prescribes it for heart protection.

Sore throat sprays or lozenges

Sore-throat spray and lozenges aren’t well-studied when it comes to breastfeeding. But they’re generally considered safe to use. They work to numb pain in the throat, but aren’t absorbed into your bloodstream. This means they aren’t likely to show up in your breast milk.

Examples of these products are:

• Phenol (Chloraseptic)

• Benzocaine / menthol (Cepacol)

Some of these products contain menthol, a chemical found in the peppermint plant. Menthol can have a cooling, soothing effect on the throat. The National Institute of Health reports that menthol does enter breast milk in small amounts, but that it’s generally considered safe.

It’s a common belief that menthol or peppermint can reduce milk supply when breastfeeding. But we don’t have any studies to back this theory up. And it’s unlikely that the amount of menthol in these products would be enough to affect your breast milk supply.

If you’re using products with menthol and notice a decrease in your breast milk supply, talk to your healthcare team. They can help determine the cause and help you decide the best way to manage your symptoms.

Stuffy nose or sinus pressure

There are several OTC options for treating a stuffy nose or sinus pressure. The medication in nasal sprays isn’t likely to enter your bloodstream in large amounts. So it’s unlikely they’ll be passed to your baby through your breastmilk. 

These include decongestant and steroid nasal sprays, such as:

• Oxymetazoline (Afrin)

• Fluticasone (Flonase)

• Triamcinolone (Nasacort)

• Phenylephrine (Neo-Synephrine)

Nasal decongestants such as oxymetazoline are likely safe to use when breastfeeding, because they aren’t absorbed into the bloodstream. But they can cause rebound congestion if they’re used for more than 3 days in a row.

Steroid nasal sprays such as fluticasone are also generally considered okay to use if you’re breastfeeding. But there isn’t as much research on their safety. And they may not provide symptom relief right away.

Good to know: Oral pseudoephedrine (Sudafed) isn’t usually a first-choice option for congestion relief when you’re breastfeeding. It’s unlikely to cause any harm, but it may reduce your milk supply and may make your infant more irritable than usual. But it’s safe to take if other options aren’t effective.

Cough

Two main OTC cough medications are considered safe to take when breastfeeding: dextromethorphan (Delsym) and guaifenesin (Mucinex, Robitussin).

Dextromethorphan helps calm a cough. The amount found in breast milk after taking it is very low, so it should be safe for your baby.

Guaifenesin is an expectorant. This means that it thins the mucus in your lungs to help you cough it up. It hasn’t been studied in breast milk, but is thought to be safe.

Runny nose or itchy, watery eyes

Antihistamines are generally safe to take when you’re breastfeeding. But there are different types of antihistamines, and they don’t all work the same way for cold symptoms.

First-generation antihistamines are better at drying up a runny nose or watery eyes caused by a cold or flu virus. But they may also cause drowsiness and irritability in your infant if you breastfeed after taking them. These include:

• Diphenhydramine (Benadryl)

• Chlorpheniramine (Chlor-Trimeton)

• Doxylamine (an ingredient in Nyquil)

Second-generation antihistamines are newer and cause less drowsiness than older antihistamines. But they work better for allergy symptoms and aren’t as effective for drying up a runny nose caused by a cold. These include:

• Loratadine (Claritin)

• Fexofenadine (Allegra)

• Cetirizine (Zyrtec)

Are there any cold medications you should avoid while breastfeeding?

Most OTC cold medications are safe to take while breastfeeding. But it’s a good idea to avoid the following products:

• Medications that make you sleepy: Use caution if you take medications that cause drowsiness, such as NyQuil or diphenhydramine. They may make it unsafe to hold your baby while breastfeeding.

• Medications that contain alcohol: Some liquid cold and flu products contain alcohol. These products can make you feel dizzy or drowsy, which can be unsafe while breastfeeding. They can also affect your baby’s sleep and ability to breastfeed.

• Oral medications that contain pseudoephedrine: As mentioned, pseudoephedrine can decrease breastmilk production. So it’s best to avoid it if possible. Keep in mind that pseudoephedrine is often included in combination products that contain the letter “D” in their name, such as Aleve-D Sinus and Cold (naproxen / pseudoephedrine).

How to safely take cold medicine while breastfeeding

You can take these steps to keep you and your baby safe when you’re breastfeeding and taking cold medicine:

• Only take medication you need. Many OTC cold medications contain several ingredients, and you may not need all of them. If you see ingredients listed for symptoms you don’t have, then it’s probably not the right product for you.

• Don’t overdo it. It’s best to take the lowest dose of medication for the shortest amount of time when you’re breastfeeding. This lowers the amount of medication your baby is exposed to.

• Time your dose around breastfeeding. For certain medications, the amount of medication in your breast milk is the lowest right before your next dose. Breastfeeding right before you take your medication may help reduce how much your baby is exposed to. But this isn’t true for all medications, so it’s still necessary to check with your healthcare team before trying a new medication while breastfeeding.

• When in doubt, ask your pharmacist. It’s easy to be overwhelmed by the number of OTC products available. If you’re not sure what the best option is, ask the experts. They can help make sure you’re choosing a product that’s safe to take while breastfeeding.

Will cold medications lower my milk supply?

Possibly. Pseudoephedrine is the main OTC cold medication that may lower milk production. Some people have reported that diphenhydramine and menthol may also lessen the production of breast milk. But clinical studies don’t seem to back this up.

Still, it’s important to remember that every person is different. What affects your milk supply may not affect someone else’s. If you start taking an OTC cold medication and notice you’re producing less milk, it’s a good idea to stop taking it and let your healthcare team know. They can help make sure there’s not something else going on.

Are there home remedies for a cold I can use while breastfeeding?

Yes, there are several ways to manage cold symptoms without medications while breastfeeding:

• Drink lots of water or other clear liquids. Clear liquids, especially warm ones, help break up mucus in your nose and chest. Adding buckwheat honey or lemon to warm tea or having sips of warm broth are great ways to get hydrated and relieve congestion.

• Take a hot, steamy shower. The steam can help open up your sinuses and nasal passages. Even if you don’t take a shower, standing in a bathroom full of steam from a hot running shower will help. If your baby’s congested, breathing steam could help them, too. Just be sure your little one stays far away from any hot water to avoid burns.

• Use a humidifier. A humidifier provides the same benefits as a steamy shower. Run a humidifier while you’re sleeping to get some relief overnight.

• Try a saline nasal spray or neti pot. If that congestion just won’t go away, you can also consider a medication-free saline nasal spray or neti pot. They use the power of saltwater to break up mucus in the nose.

• Rest. As a mom, “rest” might not be in your vocabulary as much as you’d like anymore. But if possible, try to get a bit more rest while you’re sick. It’ll help your body kick that cold a little quicker. Don’t forget to prop your head up with an extra pillow if your post-nasal drip is making you cough while sleeping.

Should you breastfeed if you have a cold?

The American Academy of Pediatrics recommends that you continue breastfeeding when you’re sick in most cases. The benefits of breast milk, such as antibodies and nutrition, are greater than the risk of passing the infection to your baby through your milk.

However, there are some steps you can take to breastfeed safely when you’re sick. Be sure to wash your hands often and consider wearing a mask while breastfeeding. This will help prevent you from passing your illness to your baby. Also, make sure you’re staying hydrated and eating a nutritious diet. It may be harder to do this when you’re not feeling well, but these steps will help make sure you’re able to continue breastfeeding.

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Written by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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