Tesslon Pearls (Benzonatate) and Breastfeeding
Tesslon Pearls (benzonatate) should be avoided during breastfeeding due to the complete absence of safety data in lactating women and the potential risk to the infant.
Rationale for Avoidance
The provided evidence does not contain any specific information about benzonatate (Tesslon Pearls) use during breastfeeding. When medications lack safety data in lactation, the standard approach is avoidance until evidence becomes available, particularly for non-essential medications 1.
Key Considerations
Lack of Data: Medications without established safety profiles in breastfeeding should be avoided when alternative treatments exist 1.
Risk-Benefit Assessment: Benzonatate is a cough suppressant used for symptomatic relief, not a life-threatening condition. The absence of data combined with the availability of safer alternatives makes avoidance the prudent choice 2.
Infant Vulnerability: The mechanism of action of benzonatate (local anesthetic effect on pulmonary stretch receptors) and its potential transfer into breast milk are unknown, creating unquantifiable risk to the nursing infant 3.
Safer Alternatives for Cough During Breastfeeding
Non-pharmacologic approaches: Humidification, adequate hydration, and honey (for the mother, not infant) are safe first-line options 4.
Acetaminophen or ibuprofen: These medications are compatible with breastfeeding and can address associated discomfort or fever 4, 5.
Dextromethorphan: While not specifically mentioned in the provided evidence, this is generally considered a safer cough suppressant option during lactation based on general medical knowledge.
Clinical Pitfalls to Avoid
Do not assume safety based on over-the-counter availability: Many OTC medications lack adequate lactation safety data 6.
Avoid the "pump and dump" misconception: If a medication is unsafe for the infant, temporary milk expression and discarding does not eliminate risk, as the medication remains in maternal circulation 5.