Chronic allergy symptoms can be uncomfortable and troublesome, and may even interfere with daily activities or become life-threateningly severe. Many nursing mothers unnecessarily avoid taking medication--or, worse, avoid breastfeeding--because of a fear that antihistamine drugs may hurt the child. Fortunately, the vast majority of antihistamine drugs are considered safe during lactation, though some allergy medications options are safer than others.
Renowned breastfeeding expert Dr. Jack Newman writes that, on average, less than one percent of a medication taken by a nursing mother is actually passed into her breast milk, and even smaller amounts are actually absorbed by the child. He emphasizes that the extremely minimal risks associated with these small doses are negligible compared to the risks of unnecessary formula feeding. Moms with allergies can get relief from their symptoms with little-to-no risk to their children.
Over-the-Counter Allergy Medicine: Loratadine
Loratadine is one of the most common allergy medications, and also one of the safest for breastfeeding mothers. As the active ingredient found in Claritin and Alavert, loratadine offers prescription-strength relief despite being available without a prescription. This, combined with the medication's quick action, makes it a popular choice for nursing moms.
Unlike diphenhydramine (Benadryl), loratadine is totally non-drowsy, and will not sedate the mother or child. It is also associated with very few side effects compared to the vast majority of other drugs, and it has been approved for use during lactation by the American Academy of Pediatrics. If possible, Claritin or Alavert should be the first line of defense against seasonal allergies for nursing mothers.
Over-the-Counter Allergy Medicine: Desloratadine
When loratadine breaks down in the bloodstream, it converts into a chemical called desloratadine. Some over-the-counter allergy medications, including the popular brand Clarinex, use desloratadine as a primary active ingredient. Since its precursor, loratadine, is considered safe for nursing moms, there is no reason to suspect that Clarinex may be hazardous.
One 1988 study demonstrated that only barely-detectable amounts of desloratadine are transferred into human breast milk-- just 0.019 percent of an adult dose. Since even smaller portions are absorbed in the child's gut, there is good reason to believe that Clarinex and other desloratadine products are safe allergy medicines for lactating mothers.
Non-Over-the-Counter Allergy Medicine: Triprolidine
Another allergy medicine that has been approved by the American Academy of Pediatrics is triprolidine, commonly sold under the trade name Actidil. Although this drug is not prescribed as frequently as some other allergy medicines, Actidil is considered to be one of the safest and most effective allergy treatments for nursing mothers.
Triprolidine is sometimes combined with pseudoephedrine, a powerful decongestant, to create products such as Actifed. These decongestants are available over-the-counter and are also considered to be safe for nursing mothers. To avoid the possible negative effects of pseudoephedrine, bresatfeeding moms should seek isolated Triprolidine unless they find it ineffective.
Over-the-Counter Allergy Medicine: Fexofenadine
Fexofenadine--also known as Allegra--is also considered to be a safe allergy medicine for breastfeeding mothers. Though it is available only by prescription, fexofenadine is associated with very few side effects and only passes into breast milk in small amounts.
While it has been approved by the American Academy of Pediatrics for use by breastfeeding moms, Allegra has not been studied thoroughly enough for its effect on lactation to make it a good first-choice. Still, it is a good choice for mothers who do not find relief from over-the-counter allergy medicine.
Other Medicines Used to Treat Allergies
Some other drugs are considered to be reasonably safe during lactation, although there are safer options. For example, cetirizine (trade name Zyrtec) has been used extensively by breastfeeding women, but its long-term effects on nursing have not been studied thoroughly. There may be better options.
Another popular allergy medicine is diphenhydramine, more commonly known as Benadryl. Though serious effects on breastfed infants are unlikely, it does appear to be present in breastmilk in detectable amounts, and it has more potential side effects for the child. Diphenhydramine may have a sedative effect on some children-- a reaction that may be dangerous for very young infants. Alternatively, Benadryl has been known to cause agitation or hyperactivity in older babies and toddlers--an effect that any sniffly-nosed mom would prefer to avoid.
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