Breastfeeding & Nasal Decongestants

Research has shown that medication taken by nursing mothers can affect the health of an infant who has ingested her breast milk. However, not all medications are harmful to a nursing infant. Over-the-counter medications for treating colds, sinus infections or allergies interact differently with the mother's body, resulting in varying levels of risk for a nursing infant.

Biology

Once a medicine or drug has been ingested, it can enter a nursing mother's milk through two processes. Most commonly, a drug is broken down in the body and then absorbed into the bloodstream. The active ingredients in the medication can be absorbed into the milk supply through an act of diffusion. Some drugs contain elements that are fat-soluble, and the high fat content of human milk results in drug absorption. Once the milk has been ingested by the infant, the active ingredients in the drug can cause side effects or an allergic reaction in the baby.

History

In 1983, researchers at the American Academy of Pediatrics launched extensive studies evaluating the risk of medication transference during breastfeeding. Their test of more than 300 medications and chemicals concluded that decongestants could result in "irritability...disrupted sleeping patterns... [and affected] thyroid activity" in an infant. These findings led many mothers to cease breastfeeding while using decongestants and other drugs.

Misconceptions

Since the time of the American Academy of Pediatrics' landmark study, newer research has shown that the new active ingredients in decongestants are not as dangerous to the health of the infant. Pseudophedrine and phenylephrine are the most common active ingredients in today's decongestants. Research by breastfeeding researcher Thomas Hale has shown that moderate use of decongestants is generally safe, although pseudophedrine can lower milk supply in some mothers.

Prevention

Decongestant nasal sprays usually are considered safe for general use for nursing mothers. Oral decongestants that use phenylephrine are also considered safe for use. Avoid multisymptom medication that treats more than just congestion, because these medications include more than one active ingredient. Nursing mothers who are on a medication that they do not want transferred to their infant can supplement with formula while pumping and then discarding breast milk for the duration of treatment.

Considerations

Even approved medications can cause a reaction in an infant. Monitor the infant to note any drowsiness, crankines, or change in appetite. Infants also can have allergic reactions to medications transferred through breast milk.