Dextromethorphan (Delsym) Safety During Breastfeeding
Delsym (dextromethorphan) is generally considered safe to use during breastfeeding, though you should consult a healthcare professional before use as recommended by the FDA drug label. 1
FDA Guidance
The FDA drug label for dextromethorphan specifically states: "If pregnant or breast-feeding, ask a health professional before use." 1 This indicates the medication is not contraindicated during breastfeeding, but warrants professional consultation before use.
Supporting Evidence for Safety
Most commonly used over-the-counter drugs, including cough medications, are relatively safe for breastfed infants, as the dose received via breast milk is generally small and much less than known safe doses given directly to infants. 2
Dextromethorphan has been on the market for many years and has never been implicated as causing harm in breastfeeding infants. 3
The general principle is that most medications appear in only small amounts in breast milk, and with proper guidance, mothers can safely continue breastfeeding while taking necessary medications. 4
Clinical Approach
When a breastfeeding mother needs cough suppression:
Weigh the risk of untreated maternal symptoms (persistent cough affecting rest and recovery) against the theoretical minimal risk of medication transfer through breast milk. 5
Women should not be discouraged from breastfeeding while taking compatible medications, given the substantial benefits of breastfeeding for both infant and maternal health. 5
Use the lowest effective dose for the shortest duration necessary to control symptoms. 4
Important Caveats
Monitor the infant for unusual sedation or changes in feeding patterns, though adverse effects from dextromethorphan in breastfed infants have not been reported in the literature. 2, 4
Avoid use if taking MAOIs or within 2 weeks of stopping MAOI therapy. 1
Stop use and consult a physician if cough persists beyond 7 days or returns with fever, rash, or persistent headache. 1