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What I know is...

You do NOT have to suffer during allergy season

Warmer weather is finally happening here in Nebraska. Most of us are beyond ready and thrilled at the signs of life growing from the ground, but our sinuses might feel otherwise. Sneezing, runny noses, stuffy noses, and itchy/watery eyes start to occur and are all symptoms of seasonal allergies. As a lactating individual, it can be hard to determine what medications are safe to take and are compatible with lactation, especially when misinformation abounds. This post will discuss the different remedies available to lactating individuals for treating these symptoms.

Saline nasal sprays and rinses: Saline nasal sprays and rinses are a great option for anyone suffering from allergy symptoms. They flush out the sinuses and clear away allergens, reducing the congestion, inflammation, and drainage. They are not absorbed into the bloodstream, so there is no concern of transfer to human milk or affect on supply. They can be used multiple times a day and are for all age ranges. Saline nasal sprays and rinses come in a variety of forms and at various price points, so they are a good first option for many.

Antihistamines: Antihistamines are another excellent option for decreasing sneezing, drainage, and itchy/watery eyes. Unlike what you may hear or read on the Internet, most antihistamines do not reduce milk supply. Second-generation antihistamines (Zyrtec, Claritin,z Allegra, Xyzal) were designed to last longer than first-generation antihistamines (Benadryl and others) to have fewer side effects like drying up bodily secretions. Second-generation antihistamines are considered compatible with lactation without risk to milk supply, and Zyrtec is the preferred antihistamine. First-generation ones can temporarily decrease milk supply, but this typically only occurs if you are using high doses consistently. Supply should rebound if any decreases are seen. Antihistamine eye drops are also available and are not absorbed, so they are compatible with lactation.

Decongestants: Decongestants are hit or miss when it comes to impact on supply. Sudafed is a true decongestant that helps with stuffy noses and decreases inflammation of the sinus passages. They DO have the ability to reduce the milk supply. One study showed a single dose of Sudafed 30mg could decrease supply by up to 50%, depending on how far out the participant was from birth. Those who were over a year postpartum saw the most significant decrease in milk supply. For that reason, I typically recommend trying other options first before taking Sudafed. Other options include Afrin nasal spray, another true nasal decongestant, and steroid nasal sprays like Flonase. Afrin is like Sudafed in how it works, but it is poorly absorbed into the bloodstream and does not have the same impact on supply as Sudafed. Steroid nasal sprays are like antihistamine and decongestant combined, which is excellent, and they do not affect milk supply. Steroid nasal sprays `````1take a few days to a week to fully kick in, which can be a downside. So fear not; there are multiple options available for lactating individuals. You do NOT have to suffer from allergy symptoms!

Contact info: Leslie Southard, PharmD, BCACP, CLC;;; IG/FB @thelactationpharmacist

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