Can I Take Cough Medicine While Breastfeeding?

If you are breastfeeding and come down with a cough or sore throat, you might wonder what medication is safe to take while breastfeeding your baby. Since everything you consume can be passed to your baby through your breastmilk, is it safe to take cough medicine?

Can medication pass into breast milk?

The medication you take while breastfeeding can pass into your breast milk. However, most medication only gets through in small amounts and rarely affects your baby. A clinical report by the American Academy of Pediatrics indicates that most medications and immunizations are safe to use during lactation.

What cough medicine is OK to take while breastfeeding?

When it comes to cough medication, most are safe to take while breastfeeding. However, you should always consult your doctor or your baby's pediatrician before incorporating any new medication into your routine. If you have a sore throat or a cough, the Infant Risk Center has provided guidance on medications that are OK to take and ones that should be avoided.

Cough medication suitable for breastfeeding persons

• Benzocaine – Commonly sold in stores as Cepacol, this medicine temporarily relieves pain associated with an itchy or sore throat. While there are no well-documented studies for breastfeeding persons, oral absorption is low, which means blood concentrations are probably too low to affect breast milk or your breastfed baby.
• Guaifenesin – Commonly sold as Robitussin or Mucinex, this medicine helps loosen mucus caused by chest congestion. While this medication has not been studied much in breastfeeding persons, the consensus is that a standard dose isn't likely to cause harm to your baby.
• Menthol – Commonly sold as Halls, Vick's, Ricola and Luden's, this medicine can relieve sore throat. There are no well-documented studies for breastfeeding persons, but due to the low dosage and first-pass metabolism, only small amounts of menthol would get into breastmilk, making it a safe option for breastfeeding persons. Remember that too much menthol can reduce your milk supply, so stick to the directions on the package and try not to take more than necessary.
• Dextromethorphan – Commonly sold as Robitussin DM, Delsym, this medication is a cough suppressant. It is the safest of all cough suppressant options and is unlikely to transfer into breastmilk. Be sure to monitor your baby for out-of-the-ordinary drowsiness or poor feeding.
• Honey – Commonly mixed with warm water to help relieve a sore throat. While you should not give honey to babies under 1 year of age due to the risk of infant botulism (a rare condition caused by Clostridium botulinum bacteria, which live in soil and dust), it is perfectly fine for the breastfeeding person to consume honey. The toxins that cause botulism do not get into breast milk. However, if you are consuming honey in your water, be sure your baby doesn't directly consume it.
• Codeine – Commonly sold as Robitussin AC, Vanacof, Tylenol #3 and Tylenol #4, this medication is used to help treat throat pain and cough, and a prescription is required. If the correct prescribed amounts are taken, it is likely fine for breastfeeding persons to take. However, there have been some cases of infants experiencing slow and ineffective breathing if codeine is taken in high doses by the breastfeeding person. It is recommended to consume less than 150 mg of codeine per day if you are breastfeeding. If you feel lethargic after taking codeine, wait to feed your baby until you are more alert.

Cough medication to avoid while breastfeeding

• Benzonatate – Commonly sold as Tesselon perles, this is a non-narcotic suppressant. While there is low to minimal transfer of benzonatate into breastmilk, the Infant Risk Center recommends avoiding this medication when possible because benzonatate can be very dangerous if taken directly by a child and cause severe toxicity at relatively low doses. For this reason, it is recommended to avoid it if possible.
• Decongestants – If you also are experiencing congestion, medications containing pseudoephedrine, such as Sudafed or Zyrtec D, should be used with caution because pseudoephedrine can decrease milk supply

What pain medicine is OK to take while breastfeeding?

If you have a sore throat, you may consider taking pain medication to help control symptoms. The Infant Risk Center offers the below guidance on pain relief medication.

Pain medication suitable for breastfeeding persons (in order of preferred medication)

• Ibuprofen – Commonly sold as Advil, Nuprin and Motrin, ibuprofen is the preferred pain relief medication breastfeeding persons should take. Very minimal amounts will be transferred through breast milk. Do not exceed more than 3.2 grams per day.
• Acetaminophen – Commonly sold as Tylenol, acetaminophen is safe to take while breastfeeding. It is recommended not to exceed 4 grams per day.
• Naproxen – Commonly sold as Aleve, there are no well-documented studies on naproxen compared to similar pain relief medications. The levels that would be transferred into breastmilk are likely low, but naproxen can take longer to eliminate from the body than other pain relief medications. If taken for short-term use or occasionally, it is likely OK. Do not exceed more than 1 gram per day.

Pain and fever medication to avoid if breastfeeding

• Aspirin – Commonly sold as Bayer. Although minimal amounts of aspirin are transferred through breastmilk, there is a potential risk of aspirin causing bleeding problems in infants. Children who take aspirin directly can also develop Reye's syndrome, which causes liver and brain swelling. However, breastfeeding persons taking aspirin for heart attacks and rheumatic fever issues should consult with the doctor. In these cases, your doctor may still recommend you take aspirin.

Will certain medications reduce my breast milk supply?

Everyone's milk supply will vary, but there are reports of medications containing menthol, pseudoephedrine, phenylephrine, decongestants and some antihistamines contributing to a decrease in milk supply. Before incorporating a medicine into your routine, talk with your doctor or lactation consultant. If you notice a reduction in your milk supply, stop taking the medication and drink plenty of fluids to help boost your supply.