Over-The-Counter Medications During Lactation

Pain Medications

Avoid products with aspirin

Preferred medications are:

• • Acetaminophen, no more than 3000mg/24 hours
  • Ibuprofen, no more than 800mg every 6 hours
  • Naproxen is less ideal than ibuprofen because naproxen has a longer 1/2-life.

Cold Medications

Avoid all oral and intranasal products with decongestants such as pseudoephedrine and phenylephrine, because these can cause a significant decrease in milk production.

Preferred medications are:

• • Guaifenesin for nasal congestion and cough
  • Dextromethorphan for a cough
  • Nasal saline preparations

Allergy Medications

Preferred medications are:

• • Non-sedating antihistamines such as loratadine, fexofenadine or cetirizine for sneezing and itchy eyes/nose, itching and
  • Stronger antihistamines such as diphenhydramine and chlorpheniramine can cause irritability in the baby and might reduce the milk production in high doses or regular use.
  • Nasal cromolyn sodium
  • Nasal steroids
  • Topical steroid creams/ointments such as hydrocortisone

Heartburn

Preferred medications are:

• • Famotidine
  • Omeprazole, lansoprazole
  • Antacids such as calcium carbonate, magnesium hydroxide, aluminum hydroxide

Constipation

Preferred medications are:

• • Docusate Sodium stool softeners
  • Magnesium hydroxide
  • Polyethylene glycol
  • Bisacodyl
  • Fiber supplements such as psyllium, calcium polycarbophil, methylcellulose fiber, wheat dextrin
  • Magnesium citrate
  • Senna

Diarrhea

Preferred medications are:

• • Loperamide Bismus subsalicylate, when used occasionally.
  • Regular use can increase salicylate levels in the infant and cause metabolic acidosis.

Motion Sickness

Preferred medications are:

• • Watch for infant sedation. It may reduce milk production with high doses or regular use.
  • Dimenhydrinate (Dramamine). It may reduce milk production with high doses or regular use.