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 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 breastfeeding mothers, but new mothers 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.

Breastfeeding Can Help Sleep

We have learned that breastfeeding can actually help with insomnia and other sleep problems, and not because young mothers are completely exhausted.

The Role of Prolactin

Nursing moms 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 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 percent still nursing their babies at six months of age and 21 percent still nursing their one year olds.

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

Safety of Antihistamine-Based Sleep Aids

Most over-the-counter (OTC) sleep aides contain antihistamines, 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 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-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).

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

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

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.

Coping with Sleep Problems While Breastfeeding

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 devises 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 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.

When Sleep Problems Persist

For women who have more than intermittent difficulties with sleep, an evaluation to look for other causes of sleep problems should be considered. 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. Keep in mind that seeing a sleep specialist does not mean you must have a sleep study, and a knowledgeable sleep physician can diagnose many common sleep problems based on your history alone.

Supplements and Sleep

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.

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 mothers 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 his mother first.

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