Are Over-The-Counter Sleep Aids Safe While Breastfeeding?

Breastfeeding Moms Produce Prolactin Which Helps With Their Sleep

Unisom, an over the counter sleeping aid. Credit: Photo Inc / Getty Images

The sleep deprivation common to new parenthood is legendary, so the thought of new mothers needing medicinal help for insomnia when they finally collapse into bed seems impossible. But it's not. A handful of over-the-counter (OTC) sleep aids are considered safe for breastfeeding mothers, but they need to balance their needs with the potential risks and side effects these drugs present to their babies.

It seems logical that nursing mothers, who either breastfeed or pump their milk every few hours around the clock, would easily shift into sleep mode once given the chance. Despite mounting sleep debt, however, their rest can easily be disrupted by anything from lingering childbirth discomfort to swollen breasts to anxiety over their new parenting role.

The Role of Prolactin

But nursing moms do have a built-in advantage for peaceful sleep compared to those who don't breastfeed. The hormone prolactin is released during nursing and promotes feelings of relaxation and calm in the mothers. Most new mothers do opt to breastfeed for some period of time, according to the US Centers for Disease Control and Prevention, with about 43% still nursing their babies at 6 months of age and 21% still nursing their 1 year olds.

Safety of Antihistamine-Based Sleep Aids

Most OTC sleep aides contain antihistamines, typically used to combat cold and allergy symptoms, such as sneezing, itching and mucus production, but antihistamines also induce drowsiness, making them useful for insomnia.

These sleep aides work by suppressing histamine, a chemical messenger in the brain that fosters alertness.

For short periods, the two active ingredients found in most OTC antihistamines are probably safe for breastfeeding mothers. If OTC sleep aids containing these active ingredients are used, their use should be limited, and the infant should be monitored for drowsiness.

These active ingredients are chlorpheniramine found in Chlor-Trimeton and Aller-Chlor, and diphenhydramine found in Benadryl and Diphenhist. Diphenhydramine is the one most commonly used in sleep aids. Some drugs contain diphenhydramine alone, such as Nytol or Sominex, and others combine it with pain relievers, such as Tylenol PM (acetaminophen and diphenhydramine).

Lactating mothers, however, should not take combination products containing aspirin. Because of its blood-thinning abilities, aspirin sometimes causes rashes or bleeding abnormalities in breastfed babies. Some experts also advise against the use of Aleve (naproxen), particularly long-term, because the medication can gradually accumulate in a baby's body.

Long-Term Use of OTC Sleep Aids

Using antihistamines to aid sleep for long periods while breastfeeding is inadvisable, according to the American Academy of Family Physicians, because their active ingredients can interfere with milk production. They can also result in adverse effects in the baby such as irritability, crying, sedation or sleep problems.

Significant adverse effects from OTC sleep aids can also result for adults. These problems include headaches, daytime drowsiness, fatigue, dizziness, constipation, vomiting, muscle weakness, nervousness or grogginess.

Consult with your physician before taking any OTC medication while breastfeeding.

Sources

"Breastfeeding: Frequently Asked Questions." cdc.gov. 27 Jul. 2007. Centers for Disease Control. 5 Feb. 2009
"Breastfeeding Introduction." sutterhealth.org. 2009. Sutter Health System. 18 Feb. 2009
"Medication Exposures During Pregnancy and Breastfeeding: Frequently Asked Questions." cdc.gov. 29 Oct. 2004. Centers for Disease Control. 3 Feb. 2009
"OTC Medicines and How They Work." familydoctor.org. March 2008. American Academy of Family Physicians. 3 Feb. 2009
"OTC Products and Certain Patient Groups." aafp.org. 2009. American Academy of Family Physicians. 3 Feb. 2009
"Over-the-Counter Medicines: What's Right for You?" fda.gov. 7 Mar. 2006. US Food and Drug Administration. 3 Feb. 2009 .
"Policy Statement: The Transfer of Drugs and Other Chemicals Into Human Milk." aappublications.org. 2001. American Academy of Pediatrics. Pediatrics 108:3(2001): 776-789.
"Pregnancy and Newborn Health Education Center: Drugs, Herbs and Dietary Supplements." marchofdimes.com. April 2008. March of Dimes. 3 Feb. 2009

 

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