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Antihistamines and breastfeeding

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

Breastfeeding can be challenging, especially with added hay fever symptoms. Although you may have relied on many products before, most state they may not be safe in breastfeeding. Unfortunately, there is no easy answer, and our clinicians at Healthwords are used to weighing up risks and benefits – some products that are labelled as "unlicensed for breastfeeding" may be an option after discussion with your doctor. With breastfeeding, the main issue is that the active ingredient in the antihistamine enters the breastmilk, which will get absorbed by the infant. Let’s arm you with the facts first before you speak to your doctor.

It’s also worth stating that hay fever, or allergic rhinitis (similar to eye and nose symptoms to any allergen), is not known to cause any harm to you or your growing baby if left untreated. It’s for your comfort if you wish to pursue treatment for your symptoms.

Doctor’s advice

What does the label mean?

When a product label states "not recommended in breastfeeding" or unlicensed, it can mean one of two things. Firstly, clinical trials or data collected from the public may have provided evidence of a damaging effect on you or your baby as it can be passed through the breastmilk and absorbed into the baby's body. These are certainly ones to avoid.

Alternatively, it may mean the drug company making the product has not done clinical trials to test for safety in breastfeeding. Drug manufacturers avoid testing on pregnant or breastfeeding women, since any birth defects or harm to babies is not worth even the smallest risk unless the drug is specifically targeted for them. However, data is collected by regulators and drug manufacturers on anyone pregnant or breastfeeding who has tried these anyway, and any undesirable effects are declared. Additionally, regulators have data on each of the ingredients based on other research and products, and this also guides advice.

So, while the label may state that they are not recommended for breastfeeding, we can review this on a product-by-product basis. In some cases, there may be no evidence to suggest a particular product causes harm to you or your baby. From a legal standpoint, the pharmaceutical companies let any risk lie with doctors and their patients, rather than taking on any liability.

What are my drug-free options while breastfeeding?

When breastfeeding, many women want to avoid taking medications, and drug-free products carry the lowest risk. They may also be enough for mild symptoms, together with practical steps to avoid pollen. Let’s consider a range of pharmacy products:

  1. Topical nasal barriers aim to trap pollen around the nostril, preventing it from entering the nose and provoking an immune response. You could apply Vaseline around the nostrils or Haymax hay fever balm.

  2. Drug-free nasal barrier sprays are inert powders or barriers that can be sprayed up the nose to prevent the trigger of histamine release and therefore hay fever symptoms. AllerBlock nasal spray is one example.

  3. Saline nasal lavage can help to wash away allergens including pollen from the nasal cavity, which may reduce ongoing irritation.

  4. Eyelid wipes can do a similar job for the eyes.

  5. Red light therapy devices are thought to suppress the mast cells that release histamine, thereby reducing hay fever symptoms.

  6. Soothing the eyes can reduce eye symptoms - Optrex Sore eye drops contain witch hazel to clean and soothe the eyes.

Can I take antihistamines?

Most manufacturers of antihistamine tablets or eye drops advise avoiding use during pregnancy. Since antihistamines may be present in breastmilk, some manufacturers advise avoiding their use in mothers who are breastfeeding. So, breastfeeding is a judgment call.

You have your own individual needs and concerns, so we would suggest you discuss this with your doctor.

Can I take a steroid nasal spray? Are decongestants suitable?

Steroid nasal sprays, such as those containing fluticasone or beclomethasone, are not known to be harmful in breastfeeding. Asthma inhalers are safe to use during pregnancy – where the steroid dose may be higher than in nasal sprays – so steroid nasal sprays are safe to use as normal during pregnancy and breastfeeding.

However, you should seek advice from your doctor about your particular medical conditions and any concerns before starting any medication.

Decongestants are unsafe in breastfeeding as they may suppress lactation, so they should be avoided.

This information is intended as a guide, so you can consider any medicated options if your symptoms are severe and not relieved by drug-free products. But we recommend you speak to your doctor before taking any of these medications during pregnancy or while breastfeeding.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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