Can I Breastfeed While Having An Allergic Reaction: Treatments

Can I Breastfeed While Having An Allergic Reaction: Treatments

Suffering from an allergy whether seasonal or all year round can make our day to day life miserable whether that be going to work, showing up for an appointment or looking after your children. In addition to this, breastfeeding your child while having an allergic reaction can bring up 101 questions. I have looked through the literature to see what treatment is suitable for a breastfeeding mother as well as other questions you might have that would affect you and your little one.

So can you breastfeed if you have had an allergic reaction? Yes, a breastfeeding mother can continue to feed her baby during or immediately after having an allergic reaction. There are medications that can be used by a nursing mother to treat the allergy that will not affect her baby or herself. These include antihistamines, corticosteroids, decongestants, allergy shots, leukotriene inhibitors, and Mast Cell Stabilizers. However, caution should be taken when deciding what medications to take. Some medications can have a sedative effect on mom and baby as well as reducing milk supply.

There is a whole host of medications out there to provide allergy relief. Below I will mention the most commonly used medicines and if they are safe to use while breastfeeding your baby. I was also excited to see the protective effects of breast milk in helping prevent allergies and how this works.

How Do You Treat An Allergic Reaction While Breastfeeding

A clipboard with the word "Allergy" surrounded by tablets, syringes to inject and creams to treat allergy symptoms

Many breastfeeding mothers may feel confused as to how exactly they can treat their allergies. This includes allergies of short duration such as hay fever or those that stay more long term such as perennial allergic rhinitis (caused by dust mites or dander). Thankfully, effective treatment can be given to breastfeeding mothers without harming their baby or themselves.

When breastfeeding your child it’s important that you make an appointment with your doctor for an individual assessment.

Corticosteroids

Prednisolone dampens the body’s response to inflammation. It is used in allergies such as seasonal allergic rhinitis (hayfever), perennial allergic rhinitis and dermatoses (e.g atopic dermatitis). The Breastfeeding Network (2017) states that prednisolone appears in breast milk in small quantities where maternal doses of up to 40mg daily are unlikely to cause systemic effects in the infant. The maximum level in breast milk will occur 1 hour after dosage. It is recommended if possible to wait 4 hours after taking the medication to minimize exposure.

Corticosteroids also come in the form of nasal sprays to help with congestion of the nasal passages. These are considered safe and the most effective for use in a breastfeeding mother.

Antihistamines

According to the NHS antihistamines are medicines frequently used to relieve the symptoms of allergies such as hay fever, hives, conjunctivitis and reactions to insect bites or stings. They are divided into two types called first and second generation antihistamines. The first generation antihistamines such as diphenhydramine (Benadryl), chlorpheniramine (Aller-Chlor), and brompheniramine (Bromine or Dimetapp) are frequently used to treat hayfever. These are known to have a sedative effect. Second-generation antihistamines such as loratadine (Claritin), desloratadine (Clarinex), and fexofenadine (Allegra) do not have any sedative properties.

So, M., Bozzo, P., Inoue, M, & Einarson, A. (2010) discuss the safety of antihistamines during pregnancy and lactation. They mention that none of the antihistamines is excreted in the breast milk in an appreciable amount so as to have any adverse effects on the breastfeeding infant. They reassure nursing moms that they can alleviate their symptoms without posing an increased risk to their infants.

However, other sources advise using non-sedative antihistamines such as loratadine (Claritin and Alavert) and cetirizine (Zyrtec). Antihistamines which have a sedative effect could result in drowsiness and irritability in the infant. A nursing mom should also avoid co-sleeping with her baby. Co-therapy with other sedating medications should also be avoided.

Decongestants

Decongestants are mostly used to help alleviate allergy symptoms such as nasal and sinus congestion. It works by reducing the fluid within the nose and therefore reducing inflammation and swelling. They are mostly used as nasal sprays with examples including oxymetazoline and phenylephrine.

One decongestant not suitable for breastfeeding mothers is called pseudoephedrine, otherwise known as Sudafed and Zyrtec D or 12 Hour Cold Maximum Strength. This can come in liquid or pill form. Although he says that the dose absorbed by the infant is very low, Hale (2019) mentions that mothers in late-stage lactation may be more sensitive to pseudoephedrine and have a greater loss in milk production. Therefore, breastfeeding mothers with a marginal or poor milk production should be cautious in using this medication.

Allergy Shots

If allergy medications are not effective or if they interact with other medicines you may be taking, allergy shots is an excellent treatment to consider. This treatment is a form of immunotherapy where each shot contains an allergen to stimulate your immune system. Your immune system eventually builds up a tolerance, which causes allergy symptoms to fade over time.

Currently there are no contraindications for receiving allergy shots during your regular intervals while breastfeeding. There is no evidence to say that injected allergens make their way into breast milk. However, it is not advised to receive your very first shot during breastfeeding due the risk of anaphylaxis.

Leukotriene Inhibitors

These medications block chemicals called leukotrines which cause allergy symptoms such as nasal congestion, runny nose and sneezing. Montelukast (Singulair) is the main leukotrine used in allergies such as hayfever. This study concluded that exposure to the infant appears to be very low and below therapeutic ranges in an infant. They state that it is probably safe to use in a breastfeeding mother. Hale (2019) also says that there have been no adverse events in breastfed infants whose mothers had taken this medication.

Mast Cell Stabilizers

Mast cell stabilizers inhibit the release of inflammatory mediators such as histamines and leukotrienes. They are usually prescribed when antihistamines are not effective or not well tolerated. One of the main mast cell stabilizers is called Cromolyn. Although no published data exists on Cromolyn during breastfeeding, maternal milk levels are likely to be very low and poorly absorbed from the baby’s gastrointestinal tract.

Is It Safe To Take Benadryl When Breastfeeding

Benadryl also known as diphenhydramine, is an antihistamine used for a number of allergic conditions. According to Hale’s Medications and Mothers’ Milk (2019) small but unreported levels are thought to be secreted into breast milk. While these levels are low, this antihistamine has a sedative effect and therefore should only be used for a short duration in breastfeeding mothers. Antihistamines with a non-sedative effect would be considered the first choice for use in a nursing mother.

Does Benadryl Stop Milk Production

There have been anecdotal reports that Benadryl suppresses milk production. However, no studies have been done to support this theory.

Does Loratidine (Claritin) Affect Milk Supply In A Nursing Mom

Loratidine (Brand name Claritin, Alavert and Clear-Atadine) is a second generation antihistamine with minimal sedative properties. Antihistamines administered by injection in relatively high doses can decrease basal serum prolactin in early postpartum women. However, suckling-induced prolactin levels are not affected by antihistamine pretreatment of postpartum mothers.

The prolactin levels in a mother with an established milk supply should not affect her ability to breastfeed. Hale’s Medications and Mothers’ Milk (2019) regards Loratadine as compatible with breastfeeding where it has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant.

Can Allergies Be Passed Through Breast Milk

A child who is at risk of developing allergies and who has been sensitized can potentially become allergic to a specific food or group of foods through breast milk. Proteins of foods consumed by the mother pass into the breast milk. Here they have the potential to trigger an allergic response in a child. According to Wombach & Riordan (2016) the amount of allergen needed to sensitize or trigger symptoms is minute. The most common symptoms caused by a food allergy include:

  • vomiting
  • diarrhea
  • colic
  • colitis
  • bloody stools
  • eczema
  • urticaria
  • rhinitis
  • fussiness
  • poor sleep patterns

Each individual child will react differently and can have a variation of some or all of these symptoms.

Breast milk Does Have Protective Properties In Preventing Allergies

Breast milk contains an antibody called immunoglobulin A (IgA) which plays an essential role in the immune system of the mucous membranes. When your baby starts on solids at around six months, the IgA system will take effect where they help create a barrier in the mucosa of the intestine and also bind any sensitizing proteins to itself. Allergic responses may be minimized or even entirely avoided. A study carried out by Saarinen and Kajosaari (1995) concluded that breastfeeding can act as a prophylactic against allergies such as eczema, food allergy, and respiratory allergies throughout childhood and adolescence.

So rest assured all the breastfeeding mothers out there. If you are experiencing the symptoms of an allergic reaction, there are effective treatments that you can safely take, which will not cause harm to your baby. Discuss your symptoms with your doctor, where they will advise and prescribe the appropriate treatment for you.

References

https://www.ncbi.nlm.nih.gov/pubmed/28002678

https://www.mayoclinic.org/tests-procedures/allergy-shots/about/pac-20392876

http://pediatricanswers.com/2016/01/11/allergy-shots-and-breastfeeding-is-it-safe/

https://www.mayoclinic.org/diseases-conditions/allergies/in-depth/allergy-medications/art-20047403

https://www.ncbi.nlm.nih.gov/pubmed/7564787

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