Around living in the UK have used at least one over-the-counter drug in the past year. While these drugs make it possible to manage symptoms that don’t otherwise – such as painkillers for headaches or cough and cold remedies – they aren’t suitable for everyone.
Author
- Dipa Kamdar
Senior Lecturer in Pharmacy Practice, Kingston University
Women who are breastfeeding may not realise some of these over-the-counter drugs should be avoided while breastfeeding. Some of these affect the breastfeeding process itself, while others may have harmful effects on the baby.
Here are five common over-the-counter drugs you should avoid when breastfeeding:
1. Oral decongestants
The average adult experiences around . While over-the-counter oral decongestants (such as pseudoephedrine or phenylephrine) found in many cold remedies can help relieve a blocked nose, these drugs should be avoided if you’re breastfeeding.
Research shows even just a can reduce milk supply. A study showed there was a significant over 24 hours. Repeated use of an oral decongestant could permanently affect the milk supply. This is because oral decongestants – the hormone which drives milk production. This is particularly concerning in mothers who have just started breastfeeding or have low milk production.
Safer alternatives are decongestant nasal sprays which contain xylometazoline and oxymetazoline. These act locally within the nose so are into the body. Saline nasal drops and steam inhalation can also be useful in relieving congestion.
2. Codeine
Painkillers are one of the .
The painkiller codeine is an opioid which can relieve short-term pain such as headaches or post-operative pain for mothers who have had or an . This kind of high-strength codeine would require a prescription.
But low-strength codeine can be purchase in a pharmacy. Over the counter, it can be found in .
Codeine passes into the breastmilk and in the baby’s brain and spinal cord. This may lead to sleepiness or breathing problems in the baby. The effect is worse in premature or sick babies – and, in at least one instance, was linked to an .
Safer over-the-counter options for managing pain are paracetamol and ibuprofen at normal doses.
3. Aspirin
Aspirin (also known as acetylsalicylic acid) is a common over-the-counter painkiller which can lower fever and inflammation. It’s found in many cold and flu medicines. Aspirin-based products (such as bismuth subsalicylate) are also found in products used to treat upset stomachs.
But aspirin can pass into breastmilk if used in high doses for long periods of time. Although the exact cause is unknown, aspirin has been linked to Reye’s syndrome in children under 16-years-old. Reye’s syndrome is a which primarily affects the brain and liver.
Some products containing aspirin may also contain high amounts of caffeine, which is added to . Caffeine acts on receptors in the brain. It’s a stimulant, so when caffeine it can lead to a restless baby, especially if they are less than six months old.
is a safer anti-inflammatory painkiller option to use while breastfeeding. For upset stomachs, over-the-counter drugs containing an are suitable.
4. Chlorphenamine
Hayfever usually occurs during the summer season. But for some, it can be a . Many people will use an antihistamine tablet to treat symptoms.
But products containing chlorphenamine specifically should not be used long-term to treat hayfever or allergy symptoms while breastfeeding. This is because chlorphenamine passes into the breast milk and to the baby. Chlorphenamine can pass into the brain and act on receptors to cause drowsiness. This can result in missed feeds and in the baby.
While occasional, small doses of chlorphenamine may be fine to use, it’s better to reach for non-drowsy antihistamine options such as . For itchy eyes, eye drops containing sodium cromoglicate are safe to use as these act locally. Similarly, steroid nasal sprays such as beclomethasone also act locally and .
5. Combined oral contraceptives
Some types of oral contraceptives are now available over the counter as part of the .
But women who are breastfeeding may not know they should avoid combined oral contraceptive pills containing oestrogen. the hormone prolactin from producing milk. If a mother takes oestrogen-containing contraception, especially in the early months of breastfeeding, it can , affecting the breastfeeding journey.
Other options, such as the the (which only uses the hormone progesterone) and other non-hormonal measures (such as the ), are safe to use during this time.
Before using an over-the-counter drug, it’s important to read the packaging or leaflet that comes with products to check it’s safe to use while breastfeeding. You can consult for advice on which drugs are safe to use, or speak with your pharmacist or GP if you’re concerned.
In many instances, the effects on milk supply can be reversible, especially with short-term use or small doses.
