What cough medication is safe for lactating (breastfeeding) women?

From the Guidelines

For lactating women with a cough, dextromethorphan (found in Robitussin DM, Delsym) is generally considered safe and is the preferred cough suppressant, as it passes into breast milk in minimal amounts 1.

Key Considerations

• Guaifenesin (Mucinex) is also safe as an expectorant to thin mucus, and can be used in conjunction with dextromethorphan.
• Most cough medications are considered compatible with breastfeeding, but it's essential to choose medications with minimal passage into breast milk.
• Avoid medications containing pseudoephedrine, which can reduce milk supply, and codeine, which poses safety concerns for infants.
• Non-medication approaches are also helpful:
  • Stay hydrated
  • Use honey (1-2 teaspoons as needed, but never for infants)
  • Try saline nasal sprays for postnasal drip
  • Use a humidifier
  • Elevate your head while sleeping

Important Safety Information

• If your cough persists beyond 7-10 days, is severe, or is accompanied by high fever or difficulty breathing, consult your healthcare provider for proper evaluation and treatment.
• Always consult with your healthcare provider before taking any medication while breastfeeding, as they can provide personalized guidance and recommendations.
• The American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases also provides recommendations for medication use during breastfeeding, including the use of prednisone and other medications 1.

From the FDA Drug Label

If pregnant or breast-feeding, ask a health professional before use. If pregnant or breast-feeding, ask a health professional before use.

No specific cough medication is explicitly stated as safe for lactating (breastfeeding) women in the provided drug labels. Both labels for guaifenesin (PO) 2 and dextromethorphan (PO) 3 advise to ask a health professional before use if breastfeeding, but do not provide direct information on safety.

From the Research

Cough Medication Safety for Lactating Women

• There are no direct studies on the safety of cough medications for lactating women in the provided evidence.
• However, some studies provide information on the safety of certain ingredients found in cough medications:
  • Dextromethorphan, an antitussive, was found to be effective in reducing cough symptoms in adults 4, 5, 6.
  • Antihistamine-decongestant combinations were found to be effective in reducing cough symptoms in some studies, but not others 4, 5, 6.
  • Expectorants, such as guaifenesin, were found to be effective in reducing cough symptoms in some studies, but not others 4, 5, 6.
• A study on contraception in lactating women found that progestin-only methods, such as progesterone rings and Nestorone implants, do not affect breast-feeding and can be used after 6 weeks to prevent transference of orally active steroids to the newborn 7.
• It is essential to note that the safety of cough medications during lactation depends on various factors, including the type of medication, dosage, and individual circumstances.
• Lactating women should consult their healthcare provider before taking any medication, including cough medications, to ensure safe use and minimize potential risks to their baby.