hi there,
I asked this question of the la leche league. have copied my question and their response below. Sorry - it's a bit long, but I found it very helpful.
I am breastfeeding my two week old baby and am suffering quite badly from
hayfever. Am I safe to take anti-histamine medication whilst breastfeeding? If so, is there any difference between the different breands/types?
Suffering from anything whist having a very young baby to care for can feel
very tough. In general, your GP should have access to accurate and up to
date information about specific drugs and their safety whilst breastfeeding.
The Breastfeeding Answer Book revised edition published by La Leche League
(RBAB) gives the following information about assessing a drug’s suitability
for use during lactation:
‘When a choice is available, the preferred drug for the breastfeeding mother
would be:
Time-tested, that is, it has been used by nursing mothers for long enough to
be known to be compatible with breastfeeding
Least toxic to the baby
Short half-life (which means the drug will be eliminated more quickly from
the mother’s body)
Least concentrated in the mother’s milk
Given in the smallest effective dose for the shortest course.’p589
It goes on to give further general information about a baby’s ability to
metabolize medications:
‘The younger the baby, the less able he will be to eliminate most drugs from
his system.
After one month of age most babies are better able to handle certain drugs
than they could not metabolize earlier. An older baby will be better able to
metabolize most drugs than a one-month-old.
Drug dosage in children is usually calculated by weight. The heavier the
child, the larger the dosage that is prescribed for him. So, too, the baby’s
weight is a factor when considering the effect of a drug taken by the
breastfeeding mother. A heavier baby will be less affected by a drug he
received through the mother’s milk than a lighter baby of the same age.’p591
The RBAB also gives a little more specific information about antihistamines:
‘Antihistamines and diuretics may reduce milk supply in some mothers. Some
over-the-counter drugs can also reduce milk supply, including large doses of
certain vitamins….antihistamines, and diet pills (which may contain caffeine
and amphetamines, which can make the baby jittery and fussy).’p164
It also gives information about the way in which a drug is administered:
‘The speed at which a drug reaches the mother’s milk and it’s level in the
milk will depend in part on how it is given. The following methods of drug
delivery are listed from fastest and highest levels in the milk to the
slowest and lowest levels in the milk:
Intravenous
Intramuscular or subcutaneous injection
Oral
Topical’p592
This may mean that it is worth asking your GP about a topical nasal spray as
opposed to an oral tablet treatment.
If you would like any further information about a specific drug before
discussing it with yours or your baby’s doctor, I would be happy to pass on
any information that I have access to. It would be helpful if you could let
me know the name of the drug, the dosage you would be considering taking and
the length of time you would be considering taking it for.
It may also be possible to consider other steps to minimizing your
discomfort from the hayfever symptoms. Some ideas that others have found
helpful are:
Wearing sun-glasses to help minimise the amount of pollen that can enter
through the eyes
Taking frequent showers
Sleeping with the windows shut as a large amount of pollen rises up in the
early hours of the morning
It is often possible to find a solution that works well for both mother and
baby. Breastfeeding can be especially important to a baby with a family
history of allergies. The leaflet ‘allergies’, published by La Leche League
(available through LLL Books whose catalogue can be obtained on the La Leche
League website
www.laleche.org.uk), states that:
"Breastfeeding protects against allergies in two ways. The first and most
obvious reason breastfed babies have fewer allergies is that they are
exposed to fewer allergens in the first months of life. They aren't given
formula based on cows milk or soy products. Less exposure to these foods
means less chance of allergy later on. The other reason breastfed babies
develop fewer allergies has to do with the development of the immune system.
At birth babies immune system is immature . Babies depend heavily on
antibodies obtained from their Mum while in the womb. Their digestive
systems are not ready for substances other than their mothers milk. At
about six weeks of age, Peyers patches in the intestines begin to produce
immunoglobins or antibodies. At six months old a baby has a functional if
immature immune system
The tendency to be allergic is often inherited from a child's mother or
father. Babies with a family history of allergy seem to have a different
immune responses than those without allergies."
The Womanly art of Breastfeeding published by La Leche League gives the
following information about taking medications whilst breastfeeding:
‘In reality, few drugs have been proven to be harmful to the nursing
infant…Formula is not the nutritional equivalent of human milk. Babies who
are formula-fed are at greater risk of illness and allergy. Also, abrupt
weaning is traumatic for other and baby. Mother may develop painfully
engorged breasts, risking a breast infection…The mother/baby relationship is
adversely affected by sudden weaning.’p352