If you have any questions about this information, you can contact the Drugs in Breastmilk team through their Facebook page or on druginformation@breastfeedingnetwork.org.uk.
Optimal treatment choices whilst breastfeeding:
Non-sedating antihistamine
Nasal spray
Eye drops
Can you take antihistamines for allergies while breastfeeding?
Whilst you may prefer to take as few medicines as possible whilst you are breastfeeding, allergies may need to be treated urgently.
Most of the drugs to treat allergies are available to buy over the counter but the leaflets may say that they are not suitable to take whilst you are breastfeeding. This does not necessarily mean that they are dangerous, merely that the drug company has not undertaken trials itself and has chosen not to recommend its use in this situation. See our factsheet on Patient Information Leaflets for more information.
For treatment of hayfever please see our factsheet Hayfever and breastfeeding
Nasal sprays
Some people have chronic allergies to things like dust mite or cat fur. Steroid nasal sprays can be very effected with virtually no passage into milk as they only act locally. (Jones 2018)
E.g. Beclometasone (Beconase®), Fluticasone (Flixonase® Pirinase®), Budesonide (Rhinocort®), Dexa-methasone (Dexa-Rhinospray®), Mometasone (Nasonex®), Triamcinolone (Nasocort®).
Other products are designed to block the passage of pollen into the nose thus preventing the reaction e.g. Prevalin allergy®, NasalGuard Allergie Block® and similar own brand pharmacy products. These will not pass into breastmilk.
Tablets
Non-sedating antihistamines are the preferred choice if you are breastfeeding:
- Loratadine (Clarityn®) (Powell 2007, Hilbert 1997),
- Cetirizine (Zirtek®, BecoAllergy®, Piriteze®, Benadryl®) reaches low levels in breastmilk and is recommended by the British Society for Allergy and Clinical Immunology (Powell 2007)
- Fexofenadine (Telfast®) is a newer antihistamine with similar low levels of transfer and no reports of adverse events (LactMed).
- Acrivastin (Benadryl Relief®) can cause drowsiness in mother and baby (Lucas 1995). As there is less research it is the least favoured option in younger babies unless it is the only drug that you find effective. In such a situation your baby should be observed for drowsiness.
Most multiple pharmacies make their own brands of these drugs. Many are both available as paediatric syrups to be given to children over 2 years.
Short courses of sedating antihistamines e.g. chlorpheniramine (Piriton®), Promethazine (Phenergan®) and Trimeprazine (Vallergan®) taken three times a day to control urticaria (nettle rash) or severe reaction to an insect bite are unlikely to cause significant drowsiness in your baby but are best avoided long term as use may cause your baby to become drowy, miss feeds and fail to thrive (LactMed).
Eye drops
Eye drops also act only locally and can be used during lactation e.g. sodium cromoglycate (Opticrom®) (Jones 2018)
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References
- Hale T. W Medications in Mothers Milk
- Hilbert J, Radwanski E, Affine MB et al. Excretion of loratadine in human breast milk. J Clin Pharmacol. 1998;28:234-9
- Jonews W Breastfeeding and Medication Routledge 2018
- Lactmed website https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
- Lucas BD J, Purdy CY, Scarim SK et al. Terfenadine pharmacokinetics in breast milk in lactating women. Clin Pharmacol Threr. 1995; 57:398-402
- Powell RJ, Du Toit GL, Siddique N et al. BSACI guidelines for the management of chronic urticarial and angio-oedema. Clin Exp Allergy. 2007; 37:631-50.
Bibliography
- British National Formulary
©The Breastfeeding Network. Published Sept 2019, last amended February 2026
