From the FDA Drug Label
If pregnant or breast-feeding: if breast-feeding: not recommended The FDA drug label does not provide a clear answer that directly supports the safety of Zyrtec during breastfeeding, but it does state that it is not recommended. Therefore, as a conservative clinical decision, it is best to exercise caution and consider Zyrtec as not safe during breastfeeding, based on the available information from the drug label 1.
From the Research
Cetirizine (Zyrtec) is generally considered safe to use during breastfeeding, with minimal amounts passing into breast milk and unlikely to cause adverse effects in most breastfed infants. The standard adult dose of 10 mg daily passes into breast milk in very small amounts, with less than 0.5% of the maternal dose reaching the infant 2. This minimal exposure is unlikely to cause adverse effects in most breastfed infants. Cetirizine is actually preferred over many other antihistamines during lactation because it causes less drowsiness and has minimal impact on milk production.
Some key points to consider when taking cetirizine while breastfeeding include:
- Taking the medication immediately after nursing or before the infant's longest sleep period to minimize exposure
- Watching for potential side effects like irritability, drowsiness, or feeding difficulties, though these are rare
- Consulting a healthcare provider if any concerning symptoms are noticed in the baby
- Discussing the risk-benefit balance with a doctor for severe allergy symptoms requiring higher doses, as they may recommend temporary adjustments to the breastfeeding schedule or alternative treatments 3, 4.
It's also important to note that while most infants tolerate cetirizine well, it's always best to consult with a healthcare provider before taking any medication while breastfeeding, especially if the infant has any pre-existing medical conditions or is taking any other medications 5, 6.