What is Tylenol Cold and Flu?

Colds and the flu (influenza) are common, especially in the winter. They're both viral infections that can make you feel ill and miserable. Tylenol Cold and Flu is an over-the-counter (OTC) product for symptom relief. OTC products are generally safe, but all medicines need to be evaluated carefully during pregnancy and breastfeeding. What can you take for a cold while breastfeeding? There are some safer alternatives that won't harm you or your baby.
Tylenol is a well-known brand of acetaminophen, also known as paracetamol. It's a safe and effective medicine for fever and pain. Tylenol Cold and Flu tablets are a combination of acetaminophen with chlorpheniramine, dextromethorphan, and phenylephrine.
Chlorpheniramine is an antihistaminic drug. It is included to provide relief from sneezing, runny nose, and other cold symptoms.
Dextromethorphan is a cough suppressant.
Phenylephrine is a decongestant. It is included to relieve a stuffy nose and air passages. It may ease sinus congestion and pressure, too.
All of these medicines are absorbed into your blood and will be passed along with your breast milk. Your baby will consume them as long as you do. Are these medicines safe to take while breastfeeding your baby?
Acetaminophen (paracetamol) safety
Acetaminophen is considered safe during breastfeeding. The amount transferred into breast milk is low. Acetaminophen is not harmful to babies at low concentrations.
Chlorpheniramine safety
Antihistamines are generally safe. They've been used for decades, and babies rarely have severe adverse effects. If you're taking this medicine, watch out for signs of excessive sleepiness or irritability in your baby.
Taking a single daily dose of chlorpheniramine at night after the last feed of the day reduces the risk to your baby. However, your milk supply may decrease if you take this drug for many days.
Phenylephrine safety
Decongestants for short courses are not likely to cause your baby much trouble. But there isn't enough information on the use of phenylephrine during breastfeeding to be completely sure. It might be better to avoid this drug.
Nose drops and sprays will also clear your stuffy nose. These methods are better for your baby because only small amounts of these medicines are absorbed into your blood and reach breast milk.
What can I take for a cold while breastfeeding?
Colds and influenza are both viral illnesses, so these medicines provide only symptom relief. They are not cures. If you have severe symptoms, you should see your doctor. They may want to test you for influenza and perhaps prescribe curative antiviral treatment. You can take some medicines at home for usual symptoms, with some precautions.
Avoid combined products like Tylenol Cold and Flu. There are four active medicines in the tablets, and the syrup of the same name contains even more. Taking each medicine you need separately will be safer for your baby. This way, you can take the ones considered safe and avoid the others.
Colds and the flu often cause high fever, body ache, or headaches. Acetaminophen (Tylenol) is considered safe to use while nursing. Instead of taking it on a fixed schedule, take a tablet only when you have a high fever. This will probably cut down your medicine intake.
Ibuprofen (Advil, Motrin) is another safe drug for pain and fever. Very little of it reaches breast milk. It is safe for babies. Ibuprofen and acetaminophen also relieve the pain of a sore throat. But you can take a lozenge or throat spray instead.
For a stuffy nose, try oxymetazoline nose drops or sprays. They have minute doses of the drug, and even these may not reach your blood and breast milk. If you do need an oral decongestant, pseudoephedrine is safe. It is present in breast milk in only small amounts. Decongestant drugs can sometimes decrease your breast milk supply.
Should you take an antihistamine? A supply of tissues can manage a running nose or watering eyes. But if you want to take a medicine for symptom relief, loratadine and fexofenadine, the non-sedating antihistamines, are probably safer. Minimal amounts reach the breast milk.
Medicines and breastfeeding
Almost all drugs you take will be present in your breast milk. Your baby's ability to remove drugs through the kidneys or metabolize them in the liver and elsewhere is very poor. Any drugs received through breast milk will stay in their body for longer and perhaps at a higher concentration.
In general, you should take as few medicines as possible when breastfeeding. If you're ill and medicines are needed, try to follow these safety principles.
- Use locally active medicines. Inhaled drugs for respiratory problems, local applications for skin infections, etc., are safest for your baby.
- You can take medicines that are safe for a child of your baby's age while breastfeeding.
- Medicines that are safe during pregnancy may not be safe while breastfeeding. Your baby has to remove the drugs without help from your own liver and kidneys now.

SLIDESHOW
Parenting Guide: Healthy Eating for Kids See SlideshowSafer alternatives
You don't always need to take medicines for a cold or a mild flu attack. Several remedies can provide symptom relief while allowing you to breastfeed safely:
- Rest and sleep. You will usually feel better if you get some rest. While you're not well, get as much sleep as your little one allows.
- Keep warm. Wear enough layers to be cozy.
- Saltwater gargles. They relieve your sore throat.
- Plenty of liquids. Drink water, juices, milk, and other healthy drinks.
- Nose drops or sprays. They relieve your stuffy nose. You'll sleep better with open air passages.
- A high pillow. It'll help if your nose gets blocked at night.
Conclusion
Almost any medicine you take will go to your baby also. Most medicines reach breast milk in small amounts. But your baby's ability to remove these medicines is also limited. You should avoid medicines as much as possible. When you need medicines for a cold or flu, avoid the combinations with multiple ingredients. Use single medicines as you need, in the lowest dose that relieves your symptoms. Using remedies that don't involve eating medicines is best for your baby.
American Family Physician: "Medications in the Breast-Feeding Mother."
National Health Service: "Common cold."
National Library of Medicine: "Tylenol Cold Plus Flu Severe Day/Night."
National Library of Medicine — Drugs and Lactation Database: "Chlorpheniramine," "Dextromethorphan."
New Zealand Medicines and Medical Devices Safety Authority: "Drug Safety in Lactation."
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