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

Breastfeeding Moms Produce Prolactin Which Helps With Their Sleep

The sleep deprivation common to new parenthood is legendary, so the thought of new mothers needing medications 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 people who are breastfeeding, but they need to balance their needs with the potential risks and side effects these drugs present to their babies.

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

Closeup glass of drink water and pills on white table with blurred background of man sleeping on sofa in living room.
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Breastfeeding Can Help Sleep

Breastfeeding can actually help with insomnia and other sleep problems, and not because of being completely exhausted. When nursing, you have a built-in biological 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.

Most people do opt to breastfeed for some period of time, according to the U.S. 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.

That said, when breastfeeding you may still suffer from sleep problems. The consequences of being overly tired with a newborn prompt many to look for remedies.

Safety of Antihistamine Sleep Aids

Most over-the-counter (OTC) sleep aids contain antihistamines, which are medications typically used to combat cold and allergy symptoms such as sneezing, itching, and mucus production.

The fact that many antihistamines induce drowsiness (a side effect if you will), makes them useful for insomnia. These sleep aids 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 people who are breastfeeding. If OTC sleep aids containing these active ingredients are used, their use should be limited, and the infant should be monitored for drowsiness.

According to the College of Family Physicians of Canada, antihistamines can safely be used while breastfeeding, and only minimal amounts are excreted in breast milk.

Antihistamines can also cause a decrease in the supply of breastmilk, so you should hydrate well to prepare. These active ingredients are chlorpheniramine found in Chlor-Trimetron and Aller-Chlor, and diphenhydramine found in Benadryl and Diphenist.

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).

When lactating, you 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 using Aleve (naproxen), particularly long-term, because the medication can gradually accumulate in a baby.

Nursing mothers should avoid medications that contain aspirin or anti-inflammatory drugs such as naproxen.

It should also be noted that medications act differently on different people, and just because a medication is considered safe overall, there may be exceptions. In addition, some people have a paradoxical response, or a response opposite to what would be expected. A medication that causes drowsiness in some might cause wakefulness.

Long-Term Use of OTC Sleep Aids

Using antihistamines to aid sleep for long periods while breastfeeding is inadvisable 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.

Adults can also have significant adverse effects from OTC sleep aids. These problems include headaches, daytime drowsiness, fatigue, dizziness, constipation, vomiting, muscle weakness, nervousness, or grogginess.

Medications such as Benadryl (diphenhydramine) may also cause weight gain, not a dangerous symptom, but something that can be disturbing to a new mother who is trying to lose her baby weight.

It's important to consult with your physician before taking any OTC medication while breastfeeding.

Coping With Sleep Problems

With the abundance of pharmaceuticals and the quick fix of taking a pill, we often forget methods to treat insomnia and sleep problems that our ancestors used.

This begins with practicing good sleep hygiene, making sure the environment of your bedroom fosters sleep, and avoiding activities that stimulate wakefulness shortly before bed. Some experts recommend that the bedroom be reserved for sex and sleep alone and that all devices be removed or at least silenced.

Sometimes sleep problems are secondary to other nuisances of pregnancy, and these concerns may have remedies. For example, addressing heartburn, leg cramps, or shortness of breath may indirectly help you sleep better.

Counterintuitively, exercise during the day can help alleviate sleep problems at night; just make sure that you don't exercise too late in the day. Some forms of exercise become difficult as pregnancy progresses, but walking is often OK up until the time you go into labor.

Some people find that scheduling an hour's walk into their daily routine makes a big difference in their ability to sleep at night. If you have other children, taking them out in a stroller while you walk may also help them (and consequently you) sleep better as well.

If you have more than intermittent difficulties with sleep, consider an evaluation to look for other causes of sleep problems. Not all sleep problems are the same, and conditions such as restless leg syndrome and circadian rhythm disturbances may require more than good sleep hygiene to address.

For some people, consultation with a sleep specialist and a sleep study are needed to clarify the causes, and thus figure out an effective solution. Since different sleep disturbances respond to different treatments, making the time to see a sleep specialist can save significant time (and physical and emotional grief) in the long run.

Seeing a sleep specialist does not mean you must have a sleep study. A knowledgeable sleep physician can diagnose many common sleep problems based on your history alone.

Nutritional Supplements/Melatonin

The use of nutritional supplements for managing every symptom for reduced libido to sleep has skyrocketed in the United States. Unfortunately, regulations have lagged behind such that it's hard to know whether the ingredients listed on the label are actually present in the amounts listed.

There is evidence, however, that the use of melatonin as a sleep aid may be effective in people who have misalignment of their circadian rhythms. There are many studies that have found melatonin to be safe and effective, and in addition to its potential benefits for sleep, has antioxidant activity as well.

An important caveat to make, and reason that many people have found melatonin to be ineffective, is that the supplement needs to be taken well before (commonly two full hours) you head off to bed. Even "fast-acting" formulas that you place under your tongue may take a good hour or more to work.

For those who use melatonin, it's helpful to know that this supplement works differently than, for example, an antihistamine. Many people find that melatonin does not make them feel drowsy, but that they fall asleep more easily once they lie down with the lights off. Don't wait until you believe the supplement is making you feel sleepy.

A caveat to this is that many sleep experts recommend that you get up if you can't fall asleep after a period of 15 minutes or so. Continuing to lie in be hoping that sleep will come may be counterproductive.

A Word From Verywell

Considering medications while breastfeeding entails thinking of the potential effects on both your own body, and that of your baby. While short term use of antihistamine products may help you jumpstart a better sleep cycle, they should be reserved for infrequent, intermittent use while nursing, and only after talking with your baby's pediatrician.

If your sleep issues are persistent or have been ongoing, it's important to take time for yourself to try and get to the bottom of the issue. New parents all too commonly put their own needs on the back burner as they focus on their new baby and other family members.

But as flight attendants are well aware, as they tell you to place your own oxygen mask before assisting others, good self-care is essential in order to care for others around you.

Disrupted sleep is not only a nuisance that can leave you irritable, but can be dangerous when reaction times are decreased while driving and much more. Give your baby a gift by taking care of yourself first.

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