When breastfeeding, many allergy medications are considered safe, but some are preferred over others due to their effects on milk supply and infant sedation.
Safe Allergy Medicines While Breastfeeding
- Non-sedating second-generation antihistamines such as cetirizine (Zyrtec), loratadine (Claritin), and fexofenadine (Allegra) are generally preferred because they are effective and have minimal sedative effects on both mother and baby
- First-generation antihistamines like diphenhydramine (Benadryl) are also considered safe, but they can cause sedation in the mother and potentially the infant, and some mothers report a decrease in milk supply, although this is not strongly supported by scientific evidence
- Nasal sprays and eye drops for allergy symptoms are recommended when possible to limit systemic exposure and reduce the amount of medication passing into breast milk
Medications to Use with Caution or Avoid
- Decongestants such as pseudoephedrine (Sudafed) can reduce milk supply by lowering prolactin levels and are best avoided if breastfeeding, especially in the early weeks postpartum
- Combination cold and allergy medications that include decongestants should be avoided or used sparingly due to their potential impact on milk supply and infant well-being
General Recommendations
- Take allergy medications right after breastfeeding to minimize the amount of drug in the milk during the next feed
- Use the short-acting forms of medications rather than long-acting ones to reduce infant exposure
- Avoid taking allergy medications during the first 6 weeks postpartum if possible, as this is a critical time for establishing milk supply
- Monitor your baby for any changes in behavior, feeding, or sleep patterns and consult your healthcare provider if you have concerns
- Allergy shots (immunotherapy) are considered safe during breastfeeding and do not affect milk supply
In summary, non-sedating antihistamines like loratadine or cetirizine are generally the safest and most recommended allergy medicines during breastfeeding. Avoid decongestants like pseudoephedrine to protect milk supply, and consider local treatments such as nasal sprays or eye drops when possible. Always consult your healthcare provider before starting any medication while breastfeeding
