How Long After Taking Hydroxyzine Can I Breastfeed?

Looking for breastfeeding advice after taking hydroxyzine? Don’t worry mama, we’ve got you covered! If you’re a breastfeeding mom who needs to take hydroxyzine for allergies, anxiety, or other conditions, you might be wondering how safe it is for your baby. Well, you’ve come to the right place. In this article, we’ll talk about everything you need to know, including how long after taking hydroxyzine can you breastfeed, the effects of hydroxyzine on breastfeeding, and guidelines for taking hydroxyzine while breastfeeding. We’ll also discuss some alternatives to hydroxyzine, such as natural remedies and other safe medications for breastfeeding mothers. So, let’s dive right in!

Understanding Hydroxyzine and Breastfeeding

The Effects of Hydroxyzine on Breastfeeding

Hydroxyzine is an anxiolytic first-generation medication derived from piperazine with a mild sedative effect. It is given orally or intramuscularly up to four times a day and is metabolized into Cetirizine, which is compatible with breastfeeding. Currently, there is limited information available regarding the use of hydroxyzine while nursing, but due to its pharmacokinetic properties (high plasma protein binding and wide volume of distribution), it is unlikely to be excreted in significant amounts into breast milk. It has been demonstrated that hydroxyzine is well-tolerated by infants for relieving itching, and because it is metabolized into Cetirizine, the risk of breastfeeding during short-term treatments is low.

However, it is essential to monitor the baby’s sleepiness and adequate feeding. It is not recommended to sleep with the baby while taking this medication because of its dopaminergic effect, which inhibits prolactin secretion and may decrease milk production during the first weeks after childbirth. When breastfeeding is well-established, prolactin levels are not correlated with milk production. Therefore, to prevent any adverse effects, close monitoring of the baby’s health is necessary while taking hydroxyzine.

What Do the Studies Say?

According to studies, the amount of hydroxyzine excreted in breast milk is still uncertain and relatively unknown. However, since hydroxyzine is metabolized into Cetirizine, it is usually assumed that its level in breast milk would be low, similar to Cetirizine. Moreover, the concentration and frequency of hydroxyzine in the infant’s plasma are relatively low compared to cetirizine and other antihistamines, which minimizes the risk of adverse effects.

In general, antihistamines that are not sedative, such as loratadine or cetirizine, are preferred when breastfeeding. Loratadine is considered safe, with no adverse effects reported in nursing infants. Only two out of 51 lactating mothers who took loratadine reported mild sedation in their infants; however, there were no other side effects. Desloratadine, a metabolite of loratadine, is also considered safe, with insignificant amounts found in breast milk.

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Chlorphenamine is the preferred sedative antihistamine with a wide range of safe use experience during breastfeeding. Hydroxyzine or promethazine can be used with caution and close monitoring only when chlorphenamine is not suitable, as they are more likely to cause somnolence and irritability in infants.

In conclusion, while there is limited information on the use of hydroxyzine during breastfeeding, it is generally safe to take antihistamines during lactation with proper monitoring and precautions. It is best to consult a healthcare provider before taking any medication while breastfeeding.

Guidelines for Taking Hydroxyzine While Breastfeeding

When it comes to taking hydroxyzine while breastfeeding, the recommended dosage should be the lowest effective dose for the shortest duration possible. It is necessary to monitor the baby closely for any adverse reactions.

Recommended Dosage

Hydroxyzine is a first-generation piperazine-derived medication with mild sedative effects. It is administered orally or intramuscularly up to four times per day and is metabolized into cetirizine, which is compatible with breastfeeding. However, there is limited information regarding the use of hydroxyzine during lactation. Due to its pharmacokinetic properties, including high plasma protein binding and broad distribution volume, it is unlikely to be excreted significantly in breast milk. It is assumed that the risk of breastfeeding during short-term treatment is low.

Moreover, hydroxyzine has been found to be well-tolerated by infants to relieve itching. It is crucial to monitor the baby’s somnolence and ensure adequate feeding. However, it is not recommended to co-sleep with the baby while taking this medication as its dopaminergic effect inhibits prolactin secretion, decreasing milk production during the early weeks after delivery. When breastfeeding is well-established, prolactin levels are not correlated with milk production.

Possible Risks and Side Effects

There is limited information concerning the use of antihistamines during lactation, and data are lacking on long-term exposure. Nonetheless, many antihistamines can be cautiously used while breastfeeding and monitoring the baby.

Non-sedating antihistamines such as cetirizine or loratadine are preferred, as recommended by the British Society for Allergy and Clinical Immunology. Significant amounts of these medications are not expected to pass into breast milk due to their high protein binding capacity. A study found that loratadine concentrations in breast milk were negligible, and only two out of 51 nursing infants reported mild sedation.

While using sedating antihistamines such as chlorphenamine, hydroxyzine, or promethazine, the baby is more likely to experience drowsiness and irritability. Hence, it is necessary to monitor symptoms closely and avoid other sedative medications if possible. It is also recommended to refrain from co-sleeping with the infant while using sedative medications due to the increased risk of sudden infant death syndrome.

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In summary, while taking hydroxyzine while breastfeeding, it is recommended to use the lowest effective dose for the shortest duration possible, monitor the baby closely, and choose non-sedating antihistamines if possible.

Alternatives to Hydroxyzine While Breastfeeding

Breastfeeding mothers have concerns about taking medication while they are nursing their infants. Although the use of antihistamines during lactation is not well researched, many antihistamines can be used safely while monitoring the baby. In this article, we will discuss alternatives to hydroxyzine while breastfeeding.

Natural Remedies and Lifestyle Changes

Breastfeeding mothers can try natural remedies and lifestyle changes to alleviate discomfort from allergies. Some natural remedies are:

  • Nasal saline irrigation: use a saline solution in your nose to help clear out allergens.
  • Avoid allergens: protect yourself and your baby from exposure to allergens that trigger allergies.
  • Wear protective gear: wear a mask or protective clothing when necessary to reduce exposure to allergens.
  • Keep the air clean: use an air purifier to reduce exposure to allergens that are in the air.
  • Stay hydrated: drink plenty of water to help flush out allergens from your body.
  • Avoid stress: high levels of stress can make allergies worse. Try relaxation techniques, such as deep breathing, meditation, or yoga.

Other Safe Medications for Breastfeeding Mothers

The Society of Obstetricians and Gynaecologists of Canada (SOGC) and the American Academy of Pediatrics (AAP) recommend cetirizine or loratadine as the preferred non-sedating antihistamines for use during lactation. These antihistamines have been found to have very small quantities in breast milk, which is expected due to their high protein-binding properties. In addition, there have been no reported adverse effects in infants exposed to cetirizine or loratadine through breast milk.

Desloratadine, which is an active metabolite of loratadine, has also been found to be very low in breast milk.

Fexofenadine, which is an active metabolite of terfenadine, has been found to be less than 0.45% of the maternal dose adjusted for weight in breast milk.

Levocetirizine, which is an isomer of cetirizine, has been found to have small quantities in breast milk, which is predicted based on available evidence and the experience of using cetirizine.

Acrivastine has not been studied extensively in breastfeeding, but it is likely to be found in breast milk in small to moderate amounts.

Chlorphenamine is the preferred choice of sedating antihistamines, but hydroxyzine and promethazine can be used with caution and close monitoring if chlorphenamine is not suitable. Sedating antihistamines can cause drowsiness and irritability in the baby, so careful monitoring is required.

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It is recommended to use the lowest effective dose for the shortest possible time, and occasional doses are preferred. The use of other sedating medications should be avoided if possible. NICE recommends avoiding co-sleeping with the baby when using sedating medication due to the increased risk of sudden unexpected infant death.

In conclusion, although hydroxyzine is not recommended while breastfeeding, there are many safe alternatives that can be used to alleviate discomfort from allergies. Natural remedies and lifestyle changes can be effective, and non-sedating antihistamines such as cetirizine or loratadine can be used safely while monitoring the baby. Sedating antihistamines should be used with caution and close monitoring.

In conclusion, if you are a breastfeeding mother who needs to take hydroxyzine, it is important to understand the effects, guidelines, and alternatives for this medication. While there is limited research on the safety of hydroxyzine for breastfeeding mothers, studies suggest that it can be used in recommended doses with caution. As always, it is best to consult with your healthcare provider before taking any new medication while breastfeeding. If you are interested in learning more about safe medication use during breastfeeding or natural remedies for common ailments, be sure to check out other articles on my blog, I Can Find It Out. Remember, knowledge is power, and I’m here to help you navigate the often confusing and overwhelming world of motherhood.

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