I'm sick! What medication can I take while breastfeeding?

In this episode of the Milk Minute, we're tackling a question we've been getting a lot lately—what to do when you're sick and still breastfeeding. With everyone (including us) battling colds and other illnesses right now, it's the perfect time to revisit this important topic. We're pulling a rerun from earlier to give you a refresher on which medications are safe, which ones to avoid, and how to manage illness while nursing.

We know it's tough to balance caring for yourself and your little one when you're under the weather, so we're here to offer some helpful guidance and reassurance. We’re wishing you all a speedy recovery and cheering you on as you navigate the challenges of being sick while breastfeeding. Tune in for all the info you need to feel more confident during this time!

Work With Us!

• Book a Lactation Consult with Heather! Click HERE for the deets.
• Book a Lactation Consult with Maureen! Click HERE to get started.

Listener question: How is weaning going for Heather?

Resources:
Maureen’s elderberry syrup recipe
https://breastfeedingforbusymoms.com/elderberry-syrup-recipe-freebie/
Mountain Rose Herbs
https://mountainroseherbs.com/
Starwest Botanicals
https://www.starwest-botanicals.com/
Pacific Botanicals
https://www.pacificbotanicals.com/
Infant Risk Center
https://www.infantrisk.com/content/cold-flu-medications-breastfeeding
LactMed (Drugs and Lactation Database)
https://www.ncbi.nlm.nih.gov/books/NBK501922/
Article on elderberries from the National Institute of Health
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848651/
Article about garlin from the National Institute of Health
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465033/
Article on echinacea from National Center for Complementary and Integrative Health
https://www.nccih.nih.gov/health/echinacea

Prefer to read the transcript? Click Here 

Transcript

This is Maureen Feral and Heather O'Neal. And this is The Milk Minute. We're midwives and lactation professionals bringing you the most up-to-date evidence for all things lactation. So you can feel more confident about feeding your baby, body positivity, relationships and mental health. Plus we laugh a little or a lot along the way. So join us for another episode. 

Welcome back to The Milk Minute everybody. Hey guys, today we are going to talk about cold and flu medicines. Yep. But first, we're going to take a question, then we're going to get into the conversation. And of course, I always want to remind you to stick around till the end, because we give an award to one of our listeners. Could be you today. Could be you.

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So today's question is from Andrea O. She says, "I'm pretty much miserable right now. I have a bad cold, and I'm super congested. Though I read it's not recommended to take decongestants while breastfeeding, I feel like my head's going to explode without one. I always suffered from bad sinusitis. Will it be okay for my milk production? I don't want it to affect my 10 week old boy." 

Yeah, we get questions like this all of the time. And so, we're going to answer that in this episode, but before we do, I want to give you the resources to look this up again. So the infant risk website has one really good page that just lists like some of the most common ingredients in cold meds and whether or not they're okay. And then you can always go to the LACTMed website and that's done by the National Institute of Health. And they have a database of basically, I mean, almost every medication I've ever searched is on there. And it's actually really easy. You just go to Google and search LACTMed +. Pepto-Bismol + Robitussin, whatever it is. And, um, sometimes if it's a combo med, you have to search each active ingredient, but that will give you really good information. Yeah. It's nice to know that you have a reliable source right there at your fingertips, no matter what. Yeah. So just bookmark those and then next time you're sick and you can't think straight, you've got it already. 

Yeah. Isn't that the bitch. Yeah, where you're like you wait until you're absolutely out of your mind ill before you try and go find the answer. And then you're in the drug store and you like, can't see straight and you're looking at them and you're like, Oh my God, I need something. You ask the pharmacist and they look at you with that shameful look in their eye. And they're like, you can't take anything. Right. You're breastfeeding. You need to suffer. And that guy's a dick. Yes. But really the LACTMed website is what providers use to double check safety information and it will site studies. It will site specific adverse events and infants. Um, it often tells you what dosage is safe. 

And, you know, Andrea, I also want to mention that there's a little bit of a difference between a sinus infection and chronic sinusitis and how you manage those two things. So, you know, we don't typically give antibiotics for sinusitis anymore, you know, unless we have any indication that it is truly a bacteria, right? You want to get that cultured before you do an antibiotics, because sometimes it's viral, you know. And we do finally acknowledge now that throwing antibiotics at everything is harmful for us. Yeah. Also sometimes when people have chronic issues like that, they're using a lot of nasal sprays and nasal sprays can actually cause rebound congestion. So it kind of throws you into this constant cycle of having a stuffy head. 

Yeah. Okay. Well, let's get into the specifics. And as I mentioned a minute ago, a lot of these brand name meds, like Robitussin or Tylenol or Afrin or Musinex, you really have to pay attention to what's listed in the active ingredients, right? Cause Robitussin D is going to be different from regular Robitussin and DayQuil and NyQuil are different. And then DayQuil D is different. So basically every time you buy something, double check what's in the active ingredients, because we're going to be talking about those specific ingredients rather than like the brand name, multi medication. Yes. Get a pen and paper, right? Yeah. Sorry. It's going to be a little confusing, but again, um, the infant risk website has most of these too. So if you bookmark that like cold and flu med page, it's, it's going to be kind of a synopsis of this episode. Yup. Okay. 

So since we're talking about nasal sprays, let's start there. Okay. Squirty, squirty. Okay. Um, this is actually going to be pretty much the only way that a decongestant is acceptable while breastfeeding. Because it's a local absorption, so it's much less likely to cause a dip in your supply. And that's the issue with decongestants while breastfeeding is that they tell all of your glands to stop secreting shit. Right. And what are your mammary glands? They're just glands like the glands in your sinuses. So a decongestant is not targeted just to the sinus glands that excrete mucus. If you take it orally, it's going to tell your whole system, like stop excreting. Yeah. You'll even have a dry vagina. Exactly. Dry eyeballs. You might even be a little constipated. I mean, everything's going to get dryer, which is really nice when you, uh, just have a nose, like a faucet, but not while you're breastfeeding. Right. But, but a nasal decongestant and is going to be the safer way to go. Yeah, because you got to think you're spraying it directly on the specific area that you want to stop secreting.

Right? It's just like a topical application, not a systemic one. So two of the popular ingredients in nasal sprays that are considered most likely safe during lactation, right? Because we don't have specific studies on using these in lactation. I'm really sorry for the way. I'm going to say literally every one of these today guys, because we don't actually like say these every day. It's like speaking Latin. Oxymetazoline and fluticasone. Oxymetazoline and fluticasone. Fluticasone, yes. So those are specifically considered safe while lactating. Again, we don't have specific studies, but we also don't have reported dips in supply, reported adverse outcomes in infants, probably safe. So, you know, you can find these in like the Musinex nasal sprays and stuff like that. 

And this is for when you're desperate, you know. You do not want to be using these every single day because that's how you get the rebound congestion. You're gonna use this when say your Tylenol is not working and you just need a squirt or two to get through the night so you can breathe, sleep. Absolutely. And also, I always recommend positioning yourself more upright. Just like your baby, you know, when your baby's congested or having reflux or something, you'd like, put them on a little wedge. You can do that for yourself too. 

Yeah. And you know how you can breastfeed your baby in a hot shower room, you know, like you, you get the shower running and you breastfeed in there? Well do the same thing for yourself. I have a little, I have a little thing planned on steam. Oh, I can't wait. Let's do it. 

Okay. We actually, I'm going to go through the over-the-counter meds. Right. And then after that, I'm going to talk about some common, natural remedies. Sweet. Yeah. So don't worry. It's in here. All right. How about you take acetaminophen?

Okay. Yeah. So acetaminophen, AKA Tylenol is a pain and fever reliever. And this is fine for lactating parents. We have a lot of good history on this medication that shows that it's pretty safe. We give it to children. We give it to babies, occasionally. You know, obviously you want to check with your provider if you feel like you need to give your baby Tylenol. Right. But what we found is the amounts excreted in milk are less than what we would give an infant. Right. Exactly. So it's very rare to have side effects in infants when you're taking Tylenol and there's been no reported effect on lactation. So if you have a little bit of a fever, if you're kind of just like achy all over, Tylenol slash acetaminophen is the way to go and you don't need to worry about taking that at all. Right. And I'm thankful for that because it's probably the most common ingredient in cold meds. So thank goodness. Acetaminophen is safe while breastfeeding. 

Well, I'm glad you brought that up because you need to be aware that if you are taking Tylenol and then you go to take a cold med, those often do have acetaminophen in them, and you don't want to be overdosing yourself. So make sure you are looking at the amount of Tylenol or acetaminophen in the cold medication, because you're not supposed to have more than four or five grams a day, depending on your weight, right? Yeah. I can't remember the exact number, but if anything says pain and fever reducer on the front, it's pretty much going to have acetaminophen in it. Right. So just be aware of that. So you don't OD on it because it can be very bad for your liver, right? Yeah. We don't want to harm your liver. That would be really not a good side effect. You watch Monty Python? Haha, yeah. We've come for your liver, but I'm not quite done with it yet. That's all right. Anyways, moving on, right.

Um, dextromethorphan. Good job by the way. Yeah, thanks. So, okay, dextromethorphan, this one is a cough suppressant, so it's going to be in most of the cough meds you take. And again, We don't have specific data on the safety of this during lactation, but it is presumed safe and unlikely that the amount that transfers into breast milk could negatively impact the infant. Right? We don't have reports of adverse reactions. However, because of that, it's recommended that we avoid this in the two months postpartum, which is kind of a good rule of thumb. Um, the most adverse reactions we see from maternal medication use are going to be in the first two or three months or with preterm infants.

Right. I mean, think about how often you're feeding during that time. I mean, some babies are eating every hour, so there's really not ever a break for your body to have a low amount of medication when your baby is nursing. Right. And just those really tiny babies process out medications, much slower, and the amount that's in your breast milk then compared to their body weight is going to be larger.

Right. So if you have, if you get a cold and you're three weeks postpartum, you're really going to want to pay a lot more attention to the active ingredients and the timing of taking the medication than if you have like an eight-month-old. Right. Especially with that older baby, if you're not sure, or you took it and you made a mistake and it probably wasn't safe, you can just kind of wait and you probably won't see a dip in your supply if you wait, five or six hours.

Right. And there's also a difference between taking a cough suppressant, which is not the same as a decongestant, by the way. A cough suppressant is literally suppressing your cough. So if you've got that dry cough, that's just constant, constant, constant that's keeping you up at night. This is okay to take.

But if you're finding yourself taking it, like every four hours, all day for four days in a row, we actually want an expectorant then, right? Yeah. So the cough suppressants, most people take at night, so you can sleep. Or again, if you have a not productive cough or you don't have a lot of mucus, you're just coughing those dry cough. So, dextromethorphan, probably okay. Sorry for all the "probablys" . We need more research on lactation and medication. 

The next one is ibuprofen. Oh gosh. You know, I take. I mean, here's the thing. Heather, how much ibuprofen do you fucking take every day? Oh my gosh. I actually have been trying to cut back because I'm realizing that. Cause you have a liver, that needs to not be bombarded by medication every day?

Well, mostly because I don't want to like poop blood, you know, and, and also I need to get to the root cause of like joint pain and things like that instead of just, you know, fixing it with ibuprofen. But I mean, here's the thing with pain relievers, just in general, when I think the appropriate use of them is so that you can rest.

The inappropriate use of them is taking them so you can work. Oh, you know what I mean? That's my problem. Yeah, because if you're taking a pain reliever, so you can work, you're going to be exacerbating the physical problem that's causing you pain. Whereas if you take them so you can sleep, you're helping yourself heal.

Right. You know, that's really good. Thanks for that reminder. I knew that, but I'm not a great patient, so it is what it is. But I get questions all the time from people that are postpartum. Can I take this ibuprofen? You know, my vagina really hurts because of my sutures. And I'm like, yes, we gave it to you in the hospital.

In fact, we probably gave you Toradol in the hospital if you really had a bad tear or an incision of some kind. And Toradol is like ibuprofen on crack. So, you know, yes, you can take ibuprofen while breastfeeding. It's actually metabolized in the gut, not in the liver. So you can, you just need to make sure that you aren't taking it like every single day for the rest of your life, because you'll end up with like gastrointestinal bleeding, which is why old people are not supposed to take it that much. Yeah. And the nice thing about ibuprofen, it has a really short half-life. So even if you are concerned about it coming into your breast milk, waiting a couple of hours is going to be actually really effective in minimizing that.

Yeah. Yeah. So if you've got a wicked sinus headache with your cold, I think ibuprofen works better for me. Some people work better with Tylenol. We're finding actually that there are certain genetics that play differently with these different drugs. So I am a total ibuprofen genetic makeup. Tylenol is like spitting into the ocean for me.

I hate being pregnant for many reasons, but one because acetaminophen is preferred over ibuprofen. And I am not an acetaminophen taker. Yeah, you definitely. If you're pregnant, listen, listening to this, you should not be taking ibuprofen past 32 weeks of pregnancy because it can actually affect your fetus' heart.

So, you know, if you're pregnant, this is different. You need to call your provider. If you're having pain that you feel like you need ibuprofen for. But, um, and also by the way, ibuprofen is the same thing as Advil, which is not a hundred percent the same as aspirin. Yeah, they're different even though they have similar functions.

Okay. So I just wanted to just let you all know that because I'll tell people you can take ibuprofen and they're like, what about Advil? Yeah. Like, yes, you can take it's the same. That's why we say, always look at the active ingredients. Right? Because something like aspirin is going to have acetylsalicylic acid, something like Advil is going to have ibuprofen.

Right? Yeah. So Advil, Motrin, et cetera. You're okay. Okay. Ooh, getting into it now. Phenylephrine, so this right, um, Phenylephrine is considered actually one of the decongestants that's probably okay while breastfeeding. You don't want to get it in like an IV. That kind of application would absolutely decrease milk production.

Um, but small oral doses are probably okay. Yep. It's considered safe while breastfeeding. It's also not very bioavailable, which means your body has a hard time absorbing and using it. So it doesn't really reach breast milk in significant amounts. And if you get this as a nasal spray, it is even better. Okay. There you go.

Okay. Phenylephrine. All right. You take this one. I can't say it. Guaifenesin. Is that really how you say it? That's how I say it? I don't even know how I would say that one.

Guaifenesin, yeah. Okay. Go ahead. I'm going to believe you. G U A I F E N E S I N. It's an expectorant and this is a very, very common ingredient in cough and cold medicine. And it helps basically to loosen up all of the junk in your lungs or your bronchioles, so you can hack it up. So it's not a cough suppressant.

It's basically just breaking apart that mucus and pulling water in so you can get it out. Right. Which you need to do. So when your lungs have a lot of mucus in them, it should be there. That's your body's immune system saying hmm, we've got something in our lungs that shouldn't be there, so we're sending out our immune system to fight that. The way that your immune system does that in the lungs is it's in that mucus, goes travels all the way down. It's like, I'm going to pick up all that bad shit and then going to travel up again and get out of your body. Yeah. So this is like Musinex, regular Robitussin and regular DayQuil. So these might have a little bit of acetaminophen in it and they'll definitely have some Guaifenesin in it.

So we're basically taking down your fever, making your body aches go away and helping you hack up whatever's in your lungs. Um, so this is the regular kind though. This is not the kind with a decongestant in it, right? And that brings us to what we should be avoiding. So pretty much everything we've talked about until this point are all things that like are probably okay.

You know, as always with any medication, there is a chance of adverse reaction, no matter what. So, you know, if you've never taken it before, like just always be careful. So let's review, let's give you the quick list. One more time of things that are probably okay while breastfeeding. Acetaminophen, dextromethorphan, ibuprofen, phenylephrine and guaifenesin. Yup. There you go. So those active ingredients are on the okay list for breastfeeding. Yes. 

Now this is, I have this section labeled "Use With Caution" because people are going to use it anyway. So we have some interesting ones in here. Antihistamines are big in this section.

Okay. And a lot of people take antihistamines not for a histamine reaction allergic reaction, but for colds and flus that have similar symptoms as some allergic reactions. And antihistamines are tough while breastfeeding, they often cause supply drops. Yep. Right. And if you have to use it for like 12 hours, that's one thing.

But if you're using it for three days in a row, you will 100% see a drop in your supply. Yeah. So let's start with doxylamine succinate, which is apparently different than the one that does not have succinate. Yep. That's actually Unisom. Yes. So one of the reasons you're told to use caution with this is that it could be so sedating that it's unsafe for you to care for your baby, or if it passes through breast milk, it's not going to be safe for an infant who say, has a history of apnea.

Right. So if you're taking it for sleep, you need to stop. Because I took it in pregnancy actually to help me sleep through the night and also to prevent morning sickness. So if you used that in pregnancy, you need to now understand that that's different. Now that you're breastfeeding, you can't use it anymore.

And we see this ingredient in a lot of the, like, Tylenol PM, NyQuil, things like that, everything that's going to like knock you out for the nights. You can finally sleep. You really don't want to be doing that when you're caring for an infant. And absolutely not when you're co-sleeping. Right. A hundred percent and same goes with diphenhydramine, which is the other antihistamine.

So the doxylamine succinate that's Unisom, and then diphenhydramine is like Benadryl. Right? Um, again, this antihistamine is gonna be sedating. It could cause milk supply to decrease over time. Small, occasional doses are probably okay. But it's just something to really be aware of. And it depends like how sensitive you are to this too.

Most people have taken Benadryl before. Right? And you probably know how you react to this. Yeah. And again, that's one that we will give you in pregnancy. But now that you're breastfeeding, it's a different ball game. Fun, fun time. Same with the next one. Right? Pseudoephedrine. This is one that I caution about. Like every single day.

 Pseudoephedrine is a decongestant and even one dose can cause a dramatic decrease in milk supply. Sudafed, anything with "ephedrine" on the end means it's kind of an upper. Right. It's to get you off the couch, get you going. Yeah. We actually use this to help people with an oversupply down regulate because it's so effective, you know, it can cause your infant to be irritable.

It's not likely to actually harm your infant. The big deal with this one is the decrease in your milk production. Yep. Absolutely. Yeah. And then in some of the prescription cold meds, we're going to have codeine. Yeah, like Tylenol three has that, which can be okay with some caution. So you have to have a prescription for that now.

So you're going to have to talk to your doctor and make sure they know you're breastfeeding and they might still prescribe you Tylenol with like a very small amount of codeine in it. If you take that, you need to observe your infant for drowsiness and central nervous system depression symptoms. And we really don't want to take this with a newborn if we can avoid it.

Right. And also if you're new, if your baby is like eight months old, for example, and you need, you feel the need, you and your provider discuss, taking Tylenol 3 with codeine. Like if you have the flu, you know, you're probably going to get this kind of prescription. Yeah. If you're dying and you like need to sleep to heal, you should breastfeed and then take the Tylenol three directly after.

Right. That way it peaks in your system before it's time to feed again. So there are a lot of medications we didn't mention, but they probably have some of these ingredients in them. So again, just always look at the back of the box. You're going to have two ingredient lists on any medication, active ingredients and other ingredients.

Just make sure you pay attention to the active ingredient box. For sure. Yeah. So let's talk about some things that are, you know, able to be used for cold and flu symptom management that we really don't need to worry about that are a little bit more herbally. Yeah. Yeah. Okay. Can I tell you my favorite? Please do.

I'm a big neti pot user, and a lot of people think it's gross, but I freaking love it. So you basically fill up this pot of salt water and you stick the nozzle in one nasal passage and you tip your head and you let all that saltwater go up in all around your sinuses and that salt water loosens up all the crap that's in there and it pours out the other side.

And it's, if you've never tried it before, it can be a little intimidating, a little scary at first, but then when you see all of those green boogers coming out of your head and you can breathe for the first time in a week, you're like, ahh, I'm going to try that every four hours. Right. If you have like an irrational fear of drowning, don't do this because it makes you feel like you're about to drown for one second, because you are filling part of your nasal you know, your entire nasal cavity with water, salt water.

It's a little burning. Yeah, it is. Um, yeah, you want to use saline. And you want to make sure it's not too hot. I've made that mistake where I was like, hot water! And then it was bad. You want it to be like body temperature. Cold isn't good either. No, no, no body temperature, water. And again, this is something you can do too much.

So, um, I'm looking at Heather because a hundred percent when she does this, I'm sure she does it like every hour. Listen, it's fine. I'm just telling everybody else out there. Don't be like Heather. When I use the neti pot, I usually do it like twice a day, morning and night. And don't use well water. You really should be using distilled water.

Tap water has chlorine in it and fluoride and all kinds of stuff, which, you know, hasn't been shown to be. I mean, it's probably fine, but it's definitely gonna be more irritating to your mucus membranes. Yeah. So, and the point is to like an un-irritate them. Right. And well water has pathogens in it sometimes.

And you don't want to be introducing some crazy pathogen into an area that's already damaged. Yeah. And it's usually like higher mineral too. And that can be tricky for your nasal passages. Distilled water or boiled, and then cooled. Right. Okay. Neti pot, have fun with that guys. Yeah. So a lot of people take like natural supplements to deal with colds and flus, which is great.

And we have some that are considered safe while breastfeeding. So again, let's go over those. Let's start with the zinc. Oh, love it. Yeah. Zinc is fun. Um, it's in a lot of those like airborne tablets and stuff, right. It, there is a caution that it should be avoided in the early postpartum. And I'm going to say, I didn't write down why, but I'm pretty sure there was a reason you can overdose on zinc. It's a metal.

Right, right. Um, yeah, it's a metal. Yeah. So it is considered likely safe. Excessive intake could have negative effects on the infant and the person who's lactating, but it's also like kind of hard to overdose on zinc. Like you'd have to take, I don't know, like 20 of those airborne tablets in a day. Um, so don't, don't exceed the recommended dosage, right?

And the reason why this is a warning that we get in lactation is cause you actually absorb zinc better while you're lactating. Uh, cause you know, everything changed, right. And you know what, we're going to be getting some interesting research out of the coronavirus and zinc because zinc was really talked about there for a long time, as far as managing symptoms or potentially shortening the amount of time that you had this viral illness.

So stay tuned for some interesting research on zinc. I'm pretty excited to read it. Yeah. Yeah. I am too. And with zinc, we usually see vitamin C. Now to be honest, The research and whether or not vitamin C helps with a cold is like pretty inconclusive. Yeah. But it's also not harmful. And you can take really large amounts of vitamin C without, um, harming yourself outside of pregnancy. In pregnancy, you can do some damage.

So you don't want to take giant amounts, especially in the first trimester. There have been some cases of it linked with miscarriage. Certainly don't take giant amounts of vitamin C, but like giant amounts. Um, however, even really high maternal supplementation levels produce really low levels in breast milk.

Yeah. Your body is only going to take really what it needs for the recipe for breast milk, as far as those like macro molecules, like vitamin C. Right. So, you know, like most of the time, if you take too much vitamin C, you're going to just pee it out. Yep. It's water soluble. So like, you know, if you think it helps you.

Even if it is a placebo effect and placebos are still very effective, aren't they? Take that vitamin C, eat some oranges, eat some lemons, whatever. Oh, and honey, so honey is great. And whenever my son has a cough and he has one of those coughs that actually is disturbing to hear, Oh God, is it like that barking?

Cough? It's horrible. More like, a velociraptor has a cold. It's like squeaky. Oh my gosh. In the walls in our house are so thin. Like you can't even fart without someone else hearing it in the next room. So when he has a cough, I'm like, Oh my God. Get the honey. And he does a honey spoon where I will put honey on a spoon and I will have him tip his head back and I will drip it down his throat. And I will really try to get it to go down slowly without him completely swallowing it right away.

And I put it in all the tea and everything, and it really does help. Yeah. And we actually have studies that show that honey can be just as effective if not more effective in treating a cough than a lot of our over-the-counter meds. Yeah. Honey's great. Yeah. I will remind you that honey is not recommended for infants under one year.

However, it is safe for you to take while breastfeeding. Yes, honey is a cool carrier too, because you can get water to mix into honey well. You can mix other medications into it. You can do herbal tinctures in it. You can actually infuse herbs into honey. That's my favorite thing. Wow. So for my son, I make an elderberry honey.

I put chamomile in there. I actually have a sleepy honey where I put some like, real sleep herbs in there and I'm like, Oh wow, it's 10 o'clock, you're still not in bed. Do you want some honey? Which you can do for yourself, too. We talked in another episode about sleep herbs and medications. And since sleep is a really difficult thing while you have a cold, you can, you know, without that chamomile or whatever it is that you need.

So that was episode 28, where we talk about sleep medication. So you know, that that might work really well in concert with some of these. Yes. Go check that out. Okay. The next one I want to talk about is vitamin D, which we also recorded an episode on. Yeah. So check out episode 31 to hear all about vitamin D and why it's so important and what you, how much you actually should be supplementing with.

Right. It is really safe to take in large doses while breastfeeding. Lactating parents should already be supplementing with vitamin D anyway. Um, and only levels above about 4,000 IUs daily have any impact on what comes through to your milk. And vitamin D supports immune functioning. It's going to help you feel better and get better, faster.

Yep. So take your cold meds. Also take your vitamin D please. And it's important for you to take Vitamin D consistently. So don't be like me or me or Maureen. Definitely stay up on your vitamin D and figure out how to make sure that that's consistent for you. Absolutely. Okay. Ooh, echinacea. Let's get into some herbs.

I love echinacea. I think it smells and tastes so delicious. Yeah. And I I'm, I'm staying really simple and accessible on the herbs here. There are thousands of herbs you could potentially take for a cold or flu, particularly considering your specific symptoms. However,  echinacea is one that's considered very safe, very likely safe during lactation.

Again, we don't have specific studies for it or any of these other fricking medications during lactation. Um, but this is a very safe, urban general, and it's well tolerated, not a lot of adverse effects in the people that take it. There's a lot of cold and flu teas that you can buy over the counter, but we always want to remind you that those tea leaves that are in those over the counter, like tea boxes that you'd get at the grocery store are probably really old. And as they age, they lose their power. So if you are using this for actual symptom management, you'll probably want to double up on your teabag. Yeah, we do have some studies on how effective  echinacea is, and they do show that it's effective in both preventing illness and shortening the duration or severity of symptoms. 

So this is a good one if you're like, Hmm, I work at a daycare and it's cold and flu season. And even with all these masks, these little children are like wiping snot on their fingers and touching me. So I'm going to take echinacea every day. I worked at a daycare for six months and I was sick for six months, but then I didn't even get a cold for two years. Yeah, seriously. I mean, honestly, I had this conversation with my husband the other day where I was like, I can't remember the last time our son was sick, maybe because he doesn't leave the house anymore. Yeah, that's true. This has been the mildest cold season for us so far because we don't go anywhere.

Exactly. Like I used to do at least once a week group activities with my son and other kids that homeschool in the area, you know, and, and now we're just not doing it. Kids that age just cannot consistently, appropriately use their mask or social distance. So we just decided not to do it even though they're outside activities.

And I'm like, Oh, wow. He's not just continually snotty from January to March. Hmm, cool. Yeah. Now actually, I'm at the point where I don't understand how it works anymore when someone does get sick. Because my neighbors that also don't go anywhere, like literally they don't do anything and they homeschool, their daughter was barfing last night. And I'm like, how, where did she even get it? Like, where are these viruses hanging out on tree trunks?

Yeah, I don't. Yeah, exactly. When I do get a cold now I'm like, Oh, and if you want to smell really bad while you are going through a cold or a flu, you can use garlic. Like this is the, that is the most true thing. Oh dear. Yeah. The studies show that garlic can actually reduce the chances of catching a cold and flu and make recovery faster.

So I know that garlic is antimicrobial and antibacterial and you can actually take an entire bulb of garlic, sprinkled some olive oil on it and bake it and it kind of pops open. And then you can actually eat the bulb of garlic. Right. And actually the trick that I used to like, because raw garlic is really good, too, is I would mince one clove of garlic, put it in a spoonful of honey and just down it. Oh, okay. And it would like make it palatable. But I'm going to say during this pregnancy, garlic is probably the most disgusting thing I've ever smelled or tasted. So right now, what I'm doing is using the odorless gel caps.

Oh, yeah. However, of course, when you're using something that's been processed like that, you need to use more, but like it's actually safe to take like literally a whole bottle of those. Garlic is a really safe herb. Exactly. It's safe. It's well tolerated. Again, we don't have specific studies during lactation, but we also don't have any reported adverse reactions from, from breastfeeding parents or their infants.

Right. But the only caution is that in the immediate postpartum period, if you are using a lot of garlic, it can actually have anti-platelet effects, which is like clotting. Right. So, you know, if it's working against your platelets and you might not be as likely to clot, if you have a bleeding thing going on postpartum.

Yeah. I'm not sure how many people are delivering a baby and then eating like a whole head of garlic. I have had some people use garlic to try to treat groupie strep infections, yes, right before delivery. And I always tell them, okay, we're going to stop it now. Yeah. Because we don't want this to prevent clotting.

Oh, that's a really good point. Yeah. Are they taking it orally or putting it in there? Vagina? Uh, usually it's both. When I, with my clients, um, cause I'm like, all right, if you're going to do garlic, like we want this to work. Yeah. Stinky. Yeah. Oh yeah. And just if caution, if you are doing a vaginal application, which I'm going to just say like, do your research first, you will taste it in your mouth.

And just like when, if you've ever used DMSO and you put it on your skin and you're like, Hmm, I taste oysters. This is terrible. Some I've never done that. It's weird. I dunno. You've never used DMSO? It's really good for joint issues. What? I need it, obviously. I actually was introduced to it by my vet because it's used in animals a lot.

And she was like, Oh yeah, you can use it too, but wear gloves. And if you're putting it on your skin, have fun tasting oysters. And I was like, excuse me. Oh, it's really weird. I don't think anyone wants to savor oysters. No, no, no, no. She was laughing at me when she said that because I got some on my skin when we were putting it on my dog.

Oh boy. Anyway. Sorry. We're talking about garlic, but I do want to mention the odor or taste of garlic has actually been known to occasionally transfer into breast milk, especially if you're using a lot. Most of the time babies don't give a shit. Sometimes they do. But, cool thing about this. This herb has a history of use as a galactagogue in Indian culture.

Yeah. So anecdotally, then we have a very long history of use for of this herb during lactation. And a galactagogue is something that makes your milk production increase. Right? Not saying it actually does that, but there are cultures where traditionally it is believed to do that. So that's cool. So elderberries, Oh, this one's my favorite.

There's a lot of different recipes out there for elderberry syrup, which you can have, like you said before, put with honey and you can make it spicy. I actually like mine with cayenne. Fun fact, I made a little graphic for everybody with a very simple elderberry syrup recipe. Yay. I think this one is my favorite it's kid friendly.

My kids absolutely love it. We usually take it all winter long, but not this year, but yeah. You know, like we live in Appalachia where these just grow everywhere. Right, right. And you know, I really like mine kind of spicy, but you can leave the cayenne out for the kids. Yeah. And it's a really, really commonly used cold and flu remedy.

We have some studies that show that it's really effective in shortening the duration or severity of symptoms. Some studies don't exactly show that. I'll mention that herbs are really hard to study because we're not studying one specific isolated compound. We're studying a whole plant when every single individual plant has different amounts of those compounds in them based on their growing conditions. So it's hard to study. Yeah. And if you're going to get an elderberry syrup online, like consider where it's coming from, make sure you're getting good quality. Make sure the soil that they grow it in is controlled. Well, I would say like avoid getting them on Amazon. Go to an herbal supplier, like Mountain Rose or Starwest or Pacific Botanicals.

Most of them sell either the dried berries that have been like really well grown and harvested, or they're going to even just sell a syrup. Like I think Mountain Rose does the syrup. I think Mountain Rose herbs does, which is nice. And you know what, here's the other thing. It's kind of cool to make it yourself because it makes your house smell amazing.

And it also kind of makes you feel like you're in control of this, the medicine in your house again. Right? I mean, my son likes to make medicines with me. He's like, Ooh, we're making potions. And I'm like, abso-fucking-lutely we are. See you're cool. Can you be my mom? Yes. Um, yeah. Yeah. So it's really easy to make.

I will make sure that the recipe is on our Instagram and Facebook. We'll put a link to it in the show notes, because it's not like a proprietary blend here. You know, this is just, I basically just have a recipe of the like proportions you need and you can add to this right. Um, when you make a syrup, you basically make a really strong tea that you cook down to about half the water you started with.

So at that time, you don't just have to have elderberries in it. You can have cinnamon, you can have ginger. Whiskey? Right. Don't put the alcohol in while you're cooking, put it in after. I want it to last. You can put echinacea in. Right. You can put all these other herbs that you'd like to use in there or flavoring. I like to do elderberry ginger and cinnamon because it tastes nice. And also those are good herbs for colds and flus. 

Okay. So elderberries, probably safe, no specific study during breastfeeding, blah, blah, blah. But they're probably fine. Okay. The last one I want to talk about is thyme. Thyme. Thyme the herb. Also, time will heal your cold in general. If you just wait, however, you don't have to wait.

You can use thyme. Yes, thyme the kitchen spice. The secret about all of these really popular kitchen spices is they're all medicinal herbs. Why do you think we started using them? Well, that's why chicken soup works so well also because protein has actually, there are studies that show that protein actually helps way more than vitamin C does in healing and preventing, you know, colds from happening.

So you have thyme in chicken soup. Sage is another medicinal herb, which is also drying. Yeah. Seriously. And if you look at, say like, okay, look at the group of herbs most used in Indian cooking, most of those are really good for your digestive function. Turmeric. Right. Cardamum. You know, you look at like all of the herbs used in Italian cooking.

You're going to have ones for your digestion and ones for your immune system. I mean, these are like kitchen herbs are amazing. And don't forget that. And by the way, Jaeger like Jagermeister, that tastes like licorice. You're recommending? I'm not recommending Jaeger, but I just wanted to remind people, like if we're talking about different cultures, they usually have some kind of a thicker drink that's meant to take in a small dose in a sharp cordial to soothe your stomach after a big meal.

So they will use Jaeger, which tastes like licorice, which has fennel in it, which calms down your digestive system. So, you know, all cooking at home does so much more for you than going out to eat because you're able to control these herbs and the quality of the herbs and keep yourself healthy. And these herbs are really then accessible.

You can get them in the grocery store. They're not going to be the highest quality, right? So probably use more, but you can also get these herbs from the suppliers that supply medicinal herbs that are really fresh. And you can grow them. Really well processed. Oh, yeah. Growing, growing oregano is like the easiest thing in the world.

Sorry if you planted it in your garden, it's there forever, now. Mint. You cannot kill. If you have somewhere nothing else will grow, why don't you put mint there? Because it will be fine and it will never leave. Don't put it somewhere. You will regret in two years. Yeah. So thyme. Let's talk about this. It's considered safe.

It's a food. It's well tolerated. And we typically use this as a steam. What? Yeah. Okay. She says we, she does not mean me and her. I've never done this. So tell me about it. Yes. Okay. So I'm just going to say, first of all, like sometimes when you are trying to get a medicine to a certain part of your body, it just, if you take it orally and you want to affect your sinuses or your lungs, it's just not very much is going to make it there.

Right. It has to go through your whole digestive system through your bloodstream, blah, blah, blah. You're going to get like the smallest amount there and that's fine. Sometimes you can drink thyme tea, whatever, and you're going to poop it out. Right, right. It's okay. But the best way to get something like this to the mucus membranes that are most effective is going to be an steam.

That's interesting. Yeah. And something like thyme has a lot of volatile components that actually translate well into an aerosol. How do you do it? So it's very easy. You put a bunch of thyme in a pot, you get it up to a boil. Stop it from boiling, right? Cause you don't want to put your face in a pot of boiling water.

Good thing you said that. Make sure it is, um, put your hand over it and make sure it's an acceptable, the steam, is an acceptable temperature. And then you just put your face over it, put a towel over your head in the pot, and then you inhale. And while you're doing this, it's going to loosen the mucus, right?

The warmth and the moisture is going to loosen that mucus. It's going to start dripping out of your nose. It's going to act as a little bit of an expectorant, but it's also. You're going to have this topical application with this really high absorption area in your body of an anti-microbial herbs that's also healing for that mucus membrane. Oh yeah. Yeah. And also, while you're bending over like that with a towel over your head, you're actually assuming a tripod position. So like with your hands on your knees, which is actually the most volume that you can take in with your lungs in that position.

So when you have just run a really long way, what do you do? You put your hands on your knees and you breathe up and down. Cause you're tired. So you're naturally doing that. So if you have a bunch of crap in your lungs and you're trying to prevent it from turning into pneumonia, put your hands on your knees, lean over a pot of steaming thyme. Take deep breaths in and out. You will cough and stay in that position. Wear a little pad, if you've got pelvic floor dysfunction so you don't pee your pants. Spit right into the pot, you know, you're just going to throw that water out anyway. Yeah. Yeah, hack up as much crap as you can. And I just want to remind people, take deep breaths.

Like if it hurts, continue to do it. You have to pop up in the bottom base of those lungs to prevent pneumonia from settling there. So, you know, take all of these things, but also positionally, there are things that you can do. Yeah. Even plain steam is fine and it's a very traditional remedy. I mean, going into a steam room when you have a cold is the thing people have done for a long time.

And there's Vicks. It's effective. Vicks has like a steam that you can also use in a humidifier, which is great and totally fine for breastfeeding as well. You can do it in a bath. You can do it in a shower. The way I do it with kids, I set up a camping tent or a blanket fort in the living room and just put the pot in there, so, right.

Yeah. And then it's fun. And it's just this really nice. It feels better. It feels better. You know, you're always going to feel better after steaming. Adding moisture to your mucus membranes also is going to help them function. They function well when wet. So stay hydrated, right? How they work. Use Liquid I V.

 Absolutely so good. Yeah. And you know what, if you're not dripping mucus into the thyme steam, while you're doing it, you can drink some of that as tea afterwards. That's fine too. Also safe, but it tastes like you're drinking spaghetti sauce. So, you know, It's fine. If you can taste anything, right? Yeah.

If you can taste anything. Exactly. Um, yeah. I just really love steam, steaming herbs, and it's, you know, breaks up your, schedule of taking this nasal spray and that oral med and whatever. You know, I love these herbal supplements. I will say also try these first, before you go to an isolated compound of medication, because there's going to be less side effects with all of these herbal things, then there will be with medication that you get over the counter. And there's just less of a risk that it's going to do anything to your baby or your milk supply. So if you go through a neti pot and thyme and elderberry and garlic and echinacea, vitamin D and honey and vitamin C and zinc. If you go through all of those and you're still dying, then you go with, you know, something on the first list.

Yeah. And you can add the medications to those herbs. These herbs don't have a laundry list of poor reactions with medications. They're really safe. These are all foods, essentially that I'm recommending to you. You know? So that's part of the reason I like things like garlic and thyme and elderberry is most people have probably had them before, you know, um. And most of them are pretty kid friendly.

Yeah. The garlic is a hard one to sell to some kids, but not with a spoonful of honey. No. And sometimes, like, I just put a bunch of garlic on pizza or something, you know? I mean, it's not going to be the most effective application, but whatever. Or again, chicken soup. Right. So if you're sick or if you feel like you want to get yourself a little bit healthier to prevent getting sick, make that chicken soup, make that elderberry syrup.

Snuggle down, watch a movie, nurse your baby. I hope we gave you some actionable tips today that can help you feel better, faster. But before we get out of here, we got to give our Milk Minute Award in the Alcove. Uh huh.

This ad is sponsored by Breastfeeding for Busy Moms. Heather here, did you know that I own a business called Breastfeeding for Busy Moms? I wanted to let you know that you can feed your baby in a way that works for you. My online breastfeeding classes can help you prepare, troubleshoot and give you the confidence you need to have a smooth breastfeeding journey. I'm always sure to include actionable ways your partner can help you in order to avoid those devastating unmet expectations arguments. If you're the kind of person that loves having personalized support, you can take advantage of my open office hours every other week for Breastfeeding for Busy Moms students.

I never leave my people hanging. If you need more than a group support chat, my students also get 25% off private consults. So pop on over to Breastfeeding for Busy Moms and prepare the best way you can, I'll see you in class. And the link is in the show notes.

Okay. Our award this week goes to Christina. She just went back to work after having twins and she was able to collect enough milk for them, just with the Haakaa. She didn't even have to pump. Holy crap. Yeah. That's awesome. So basically she's nursing on one side, maybe tandem nursing, and then using the Haakaa.

How is she even doing that? Christina, what a bad-ass. Christina, we're going to give you the Haakaa hacker award, because if you were able to hack that Haakaa, while feeding two babies with only two boobs, I think that you definitely get the hacker award! That's amazing! How in the world did you even do that? In fact, email me and tell me how you did that.

I would love to know just the sequence of it. I need to know how you did that so I can recommend it to other people when they ask me specifically, because I've never had twins and I can't even fathom the amount of activity those breasts have been seeing. Absolutely. Well. I'm just going to remind you all that you're all winners and you all deserve an award.

And if you would like an award in one of our future episodes, you can send us a message on Facebook or Instagram or email MilkMinutePodcast@gmail.com and tell us. Like brag on yourself because you deserve it. You're doing a fucking great job. Yeah. And put in the subject line, my breastfeeding win. That way we can find you easily.

Thanks guys. Yeah. Thanks for coming. And we hope you stay healthy and feel better, faster if you're sick. Bye-bye bye-bye. Thanks for listening to The Milk Minute. If you haven't already please like, subscribe and review our podcast wherever you listen. If you'd like to support our podcast, you can find us on Patreon at Patreon.com/MilkMinutePodcast.

To send us feedback, personal stories, or just to chat, you can send us an email at milkminutepodcast@gmail.com.