What over-the-counter medication do you suggest for a nursing mother who has cold/flu symptoms? Is it okay to use formula to feed a nursing baby when the mom is sick?

--Susan

Most of the time, you do not need to stop nursing due to illness, especially if the illness is viral (like a cold) and merely requires time and some TLC to help you get over it. Also, you will produce antibodies to the particular infection to which you have been exposed, and by continuing breastfeeding you will pass these protective antibodies on to your baby. The best bet is to try to use the non-drug remedies first -- lots of fluids, especially hot drinks like tea with honey and lemon; chicken soup (it has been scientifically studied and it really does help); extra vitamin C; and plenty of rest.

If you must take over-the-counter medications for symptoms that do not respond to the above measures, use single-ingredient preparations rather than multi-symptom formulas. For instance, if you have a cough keeping you awake at night, use a single-ingredient cough suppressant instead of a cough suppressant-decongestant formula. Most cough syrups contain either guaifenesin or dextromethorphan, both of which are safe to use during breastfeeding. Antihistamines (diphenhydramine is the most common one) are also safe, although they may cause baby to be drowsy. In very high doses, antihistamines, especially in combination with decongestants, may interfere with milk supply. Decongestants are best used via nasal spray and only for a few days; nasal-spray versions of most medications deliver most of the dose to mom and less to nursing baby. Oral decongestants (ephedrine, pseudoephedrine, phenylpropanolamine) should be used in the lowest dose possible, as they may cause baby to be fussy or agitated and may interfere with milk supply. Lozenges for a sore throat are no problem. Always check with your doctor before using any medication, just to make sure it is safe.

Excellent resources for information on breastfeeding include The Nursing Mother's Companion by Kathleen Huggins, The Womanly Art of Breastfeeding by La Leche League International, and your local La Leche League (1-800-LA-LECHE).