Seasonal allergies can affect women at any stage of life, including during lactation. Fortunately, dedicated mothers do not have to choose between effective allergy treatment and a healthy breastfeeding relationship. The American Academy of Family Physicians (AAFP) considers many antihistamine drugs to be safe for women who are nursing. While the AAFP does not recommend Cetirizine (Zyrtec) as a primary option for breastfeeding mothers, the organization supports the use of Zyrtec if other treatment options have failed.
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Lactation expert Dr. Jack Newman, author of "The Ultimate Breastfeeding Book of Answers," notes that most pharmaceutical drugs pass into breast milk in very small quantities; in general, these amounts are usually insignificant and do not harm the breastfed child. Newman also notes that the known risks of formula feeding generally outweigh the hypothetical risks associated with breastfeeding while taking medication. Antihistamines like Zyrtec can help to treat hives, rhinitis and other allergy symptoms in nursing mothers and pose little or no known threat to a breastfed child.
Zyrtec offers several benefits as a treatment for allergies in breastfeeding mothers. Unlike diphenydramine (Benadryl), Zyrtec is not a sedative and will not generally cause drowsiness in the patient or her breastfed child; this feature is particularly important for the mothers of breastfed newborns. Zyrtec is also recommended instead of stimulant decongestants like pseudoephedrine (Sudafed) because it does not cause restlessness or hyperactivity. Clinical pharmacologist Dr. Thomas W. Hale, author of "Medication and Mother's Milk," notes that antihistamines like Zyrtec have no known effect on breast milk supply.
Dr. Thomas Hale rates all prescription and over-the-counter drugs on a five-point scale for nursing mothers, with L1 indicating "safest" and L5 indicating "unsafe." Dr. Hale places Zyrtec in risk category L2 for breastfeeding mothers, alongside other common antihistamines like loratadine (Claritin). Zyrtec earns an L2 rating because animal tests indicate that roughly 3 percent of the drug is passed into breast milk. According to Dr. Thomas Hale's guidelines, Zyrtec is preferable to fexofenadine (Allegra) but not as safe as triprolidine (Actidil).
The American Academy of Family Physicians recommends corticosteroid drugs like beclomethasone (Beconase), fluticasone (Flonase) and cromolyn (Nasalcrom) for women who are breastfeeding. These drugs do not appreciably pass into breast milk because they work locally rather than systemically. Home remedies like steam inhalation, saline rinses and a dairy-free diet can also effectively reduce allergy symptoms without any negative side effects for the breastfed child. AAFP recommends Zyrtec as an allergy treatment if other treatment options have failed.
While Zyrtec is generally regarded as safe for breastfeeding mothers, lactating women should not take any prescription or over-the-counter drug without first consulting a lactation consultant or medical practitioner. Zyrtec may cause side effects such as dizziness or mild confusion, and it can interact negatively with sedative drugs, including narcotics. Contact your doctor immediately if you or your breastfed child demonstrate symptoms of a serious adverse reaction or if your allergy symptoms do not improve with treatment..