While a variety of allergy medications are considered safe for use during breastfeeding, most of these do pass into your breast milk, and some can interfere with feedings by reducing your milk supply. To ensure the safest option for you and your infant, always speak with your health care provider before using any allergy treatment. The American Academy of Family Physicians also recommends taking medication immediately after breastfeeding to reduce any possible risk to your infant.
Safe Allergy Medications
There are two generations of antihistamines available for the treatment of allergy symptoms. First generation antihistamines have been on the market longer, but are associated with more intense side effects, including drowsiness, dry mouth and dry eyes. These antihistamines, such as diphenhydramine (Benadryl), brompheniramine (Dimetapp) and chlorpheniramine (Chlor-Trimeton) may be safe for use during breastfeeding, but they can reduce your milk supply and cause symptoms in your infant, including drowsiness and fussiness.
Second generation antihistamines, including cetirizine (Reactine), fexofenadine (Allegra), and loratadine (Claritin) cause fewer known side effects for both mother and the breastfeeding infant, and are recommended for short-term use by the American Academy of Family Physicians.
While there are a variety of allergy medications that are safe to use while breastfeeding, many are combined with other medications in a single pill or liquid form when you purchase them over-the-counter at a local pharmacy. For example, pseudoephedrine is a common decongestant that is often found in over-the-counter formulas that contain other drugs.
Always speak with your health care provider prior to choosing an appropriate allergy medication and read the ingredients list on the label to be certain all drugs within the medication are safe for use while breastfeeding.
Unsafe Allergy Drugs
Several allergy and sinus medications are potentially hazardous and should be avoided while breastfeeding. For example, the drug clemastine (Meclastin) can cause sedation and irritability in the breastfeeding infant, and as much as 5.2 percent of the dose is passed through breast milk, in comparison to 0.7 percent of each dose of fexofenadine and 0.29 percent of loratadine, according to "de Swiet’s Medical Disorders in Obstetric Practice." Caution is also recommended in using pseudoephedrine (Sudafed). Milk production is reduced and as much as 4.7 percent of each dose passes into breast milk.
When an allergy medication must be used longer term, the American Academy of Family Physicians recommends opting for a nasal steroid or cromolyn inhaler, such as Intal. These medications are designed to work locally, not systemically, meaning minimal amounts pass into breast milk. The Texas Tech University Health Sciences Center also recommends saline rinses as a natural way to deal with your allergy symptoms without adding risk to your infant.