Over-The-Counter Medications During Lactation

Pain Medications

Avoid products with aspirin
Preferred medications are:

1. Acetaminophen, no more than 3000mg/24 hours
2. Ibuprofen, no more than 800mg every 6 hours
3. 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:

1. Guaifenesin for nasal congestion and cough
2. Dextromethorphan for a cough
3. Nasal saline preparations

Allergy Medications

Preferred medications are:

1. Non-sedating antihistamines such as loratadine, fexofenadine or cetirizine for sneezing and itchy eyes/nose, itching and hives
2. 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
3. Nasal cromolyn sodium
4. Nasal steroids
5. Topical steroid creams/ointments such as hydrocortisone

Heartburn

Preferred medications are:

1. Famotidine
2. Omeprazole, lansoprazole
3. Antacids such as calcium carbonate, magnesium hydroxide, aluminum hydroxide

Constipation

Preferred medications are:

1. Docusate Sodium stool softeners
2. Magnesium hydroxide
3. Polyethylene glycol
4. Bisacodyl
5. Fiber supplements such as psyllium, calcium polycarbophil, methylcellulose fiber, wheat dextrin
6. Magnesium citrate
7. Senna

Diarrhea

Preferred medications are:

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

Motion Sickness

Preferred medications:

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