Can I take DayQuil while breastfeeding?

What is in DayQuil?

The DailyMed label for Vicks DayQuil Cold & Flu LiquiCaps lists 3 active ingredients in each LiquiCap. An adult dose is 2 LiquiCaps every 4 hours, with no more than 8 in 24 hours.

Other DayQuil products have different formulas. DayQuil Severe adds guaifenesin, and DayQuil-D uses pseudoephedrine instead of phenylephrine (and also adds guaifenesin). Read the active ingredients on your own box before you use this page.

• Acetaminophen 325 mg - pain reliever and fever reducer. It is the same drug as Tylenol.
• Dextromethorphan HBr 10 mg - cough suppressant.
• Phenylephrine HCl 5 mg - nasal decongestant.

What does LactMed say about each ingredient?

LactMed is the NIH database on medicines and breastfeeding. Here is how it summarizes each part of DayQuil:

• Acetaminophen - a good choice for pain and fever in nursing mothers. Amounts in milk are much less than the doses usually given to babies, and side effects in breastfed babies appear to be rare.
• Dextromethorphan - when used as a cough syrup, amounts of the drug and its active breakdown product in milk are very low and are not expected to affect the baby. LactMed says it is best to avoid products with a high alcohol content while nursing, so check liquid cough medicines for alcohol.
• Phenylephrine - very little of an oral dose gets into the body, so it is unlikely to reach the baby. The main concern is your milk supply: LactMed says oral phenylephrine might decrease milk production, and an alternate drug may be preferred, especially with a newborn or preterm baby.

Can a decongestant lower my milk supply?

It can. The clearest warning is for pseudoephedrine, the decongestant in DayQuil-D. LactMed says a single dose lowers milk production in the short term and repeated use seems to interfere with lactation. It says mothers whose milk supply is not yet well established, or who are having trouble making enough milk, should not take it. It may also occasionally make babies irritable.

For phenylephrine, the decongestant in regular DayQuil, LactMed's wording is less certain: it says oral phenylephrine might decrease milk production. That is why it suggests another drug when you can, especially with a newborn or preterm baby.

If you already took a dose or 2 of DayQuil, try not to worry. LactMed's summaries say little of these 3 ingredients reaches your baby, and none of them says to stop breastfeeding. Watch your supply, and if it seems to drop, talk with your doctor or a lactation consultant.

LactMed notes that phenylephrine nasal spray is less likely to affect milk supply than the oral form. Ask a pharmacist how long you can use a nasal spray before you start one.

What can I take instead of DayQuil?

Single-ingredient products let you treat the symptom you have without taking a decongestant you may not need. Use one product per ingredient, and do not double up.

• Fever, aches or sore throat - plain acetaminophen, such as Tylenol. Do not take it with DayQuil or any other product that has acetaminophen. The DayQuil label warns that severe liver damage may happen if you take more than the daily maximum, use it with other acetaminophen products, or have 3 or more alcoholic drinks a day while using it.
• Cough - a single-ingredient dextromethorphan cough medicine. LactMed says to avoid products with a high alcohol content while nursing, so check the label, and do not add it on top of DayQuil, which already has dextromethorphan.
• Pain where ibuprofen works better - the NHS says paracetamol (acetaminophen) is usually the best painkiller while breastfeeding, but ibuprofen (Advil, Motrin) can often be used if needed. It says to check with a pharmacist or doctor before using ibuprofen while breastfeeding. Do not take ibuprofen with another NSAID, such as naproxen or aspirin.
• Stuffy nose - ask a pharmacist before any decongestant pill, and skip pseudoephedrine if your supply is new or low.

Can I take Tylenol and Advil together while breastfeeding?

The NHS says adults can take paracetamol at the same time as ibuprofen if needed, but suggests trying each one on its own first to see if it relieves your pain. MedlinePlus is stricter: it says not to take nonprescription ibuprofen with any other medicine for pain unless your doctor tells you to.

Because sources differ, ask a doctor or pharmacist before combining them, especially if you take other medicines. The NHS lists some blood thinners such as warfarin, steroids, antidepressants and blood pressure medicines as ones that may not mix well with ibuprofen. Remember that DayQuil already contains acetaminophen, so DayQuil plus Tylenol is a double dose of the same drug.

Who should ask before taking DayQuil at all?

The DayQuil label lists people who should check with a doctor or pharmacist first, whether or not they are breastfeeding:

• Do not use if you take a prescription MAOI, or for 2 weeks after stopping one.
• Ask a doctor first if you have high blood pressure, heart disease, liver disease, thyroid disease, diabetes, or trouble urinating from an enlarged prostate.
• Ask first if you have a cough with a lot of mucus, or a long-lasting cough from smoking, asthma or emphysema.
• Ask a doctor or pharmacist if you take the blood thinner warfarin.
• High blood pressure after birth counts - if you have high blood pressure now, including high blood pressure that started in pregnancy or after birth, the label's high blood pressure warning applies, so ask a doctor first.