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When it’s cold and flu season, nearly everyone has a rough time, including breastfeeding moms. It’s hard enough to get through the day with a runny nose or a sore throat. It’s even harder when you’re responsible for feeding a baby! Whether browsing the pharmacy or cold medicine aisle, many a new mom may wonder which cold or flu medications are safe with breastfeeding. They may want to know which ones could affect milk supply or a breastfed baby. Zicam products are popular, but are they safe for breastfeeding parents? Today’s post will go into what Zicam is, who may use it, and how different variations could affect breast milk.
Let’s start with some good news.
Since small amounts of zinc supplements while breastfeeding are usually okay, the zinc part of most Zicam products is also usually okay for a few days while breastfeeding.
Below, I’ll go into detail about the different products and what other ingredients to consider with breastfeeding.
What is Zicam?
Zicam is a popular line of over the counter products advertised to help with cold symptoms, runny nose, and nasal congestion. Although the product has claims of homeopathic remedies, today I’m focusing on the listed “active ingredients,” with these products. (Homeopathic treatments are beyond the scope of this article. I do need to note that the federal drug administration (FDA) has not approved any homeopathic treatments. There is limited scientific evidence that homeopathic medications are effective).
I’m also going to focus on the products advertised for colds and nasal congestion, although the Zicam product line is more extensive.
Active ingredients in Zicam and breast milk
Although other ingredients are listed, the active ingredients are often different formulations of zinc, so I’ll focus on how that affects breastfeeding and human milk. It’s worth mentioning that the “active ingredients” are the ones that have been shown to actually affect the body in the amount listed on the label.
Zinc supplements with or without a cold
The Recommended Dietary Allowance (RDA) for adults (over age 18 years of age) of zinc is 11 mg a day for men and 8 mg for women.
If someone is breastfeeding, then they need 12 mg daily. (Even pregnancy requires a bit more than normal at 11mg daily, which is why it’s included in a prenatal vitamin).
No healthy adult should take more than 40mg in a day. In other words, less than 40mg isn’t expected to cause health problems.
Why would someone take a zinc supplement?
First, humans do need zinc as part of their daily diet. It’s an essential mineral and helps support the immune system. That being said, it can definitely be found in a typical American diet (especially a diet that includes animal products, like meat).
As mentioned earlier, someone may choose to take a supplement at the first sign of a cold in order to try to shorten how long their cold lasts.
How much zinc can breastfeeding parents take?
The amount of zinc that a breastfeeding parent can take has not been well studied. However, this small study in Italy showed that short-term use supplements of 20mg of zinc did not affect breast milk. Other studies are less conclusive about zinc supplements affecting breast milk.
Since there is limited research in zinc supplements and lactation in people who already have enough baseline zinc, it’s generally recommended to stay under the recommended “upper limit.”
This is not information about zinc and pregnant women. This article only refers to lactating people.
The Upper Limit of Zinc
Again, this upper limit is defined as 40mg a day for a few weeks. It’s not just the excess zinc that’s problematic, it’s also how zinc interferes with other things in the body, like copper and other medications. So, taking too much extra zinc on a regular basis can result in side effects leading to a host of other issues.
To be clear, I am not referring to people who are zinc-deficient, meaning their typical diet or supplements do not already provide enough zinc. This is just for people who have enough zinc normally, but would like some extra to help out with their colds.
Also, please note that I am not recommending zinc supplements be given directly to babies, breastfed or not.
So, which Zicam products are safest while breastfeeding?
First, please discuss any supplements with your own doctor. Zinc found in Zicam can interfere with some antibiotics, for example. And some medical conditions make someone at higher risk for zinc deficiency. So, this article is not any kind of medical advice. It’s just for educational purposes and general information.
Again, since a modest amount of a zinc supplement while breastfeeding is usually okay, the zinc part of many Zicam products are also usually okay to use for a few days while breastfeeding.
As there are different ways to take products (nasal spray versus lozenge for example) and some contain other active ingredients, let’s break it down more.
Zicam throat sprays and breastfeeding
One theory for why zinc supplements may be helpful is due to when a cold virus comes into contact with the zinc itself. Where does this often happen? In the nose and throat.
For this reason, the throat spray (“Zicam® Cold Remedy Arctic Mint Oral Mist” affiliate link) may then be a reasonable option. Less of the ingredients are going to be absorbed into the blood stream and therefore even less into breast milk (see this post on why this is the case). And, the active ingredients (zinc) are right there in the throat where they may come into first contact with the virus.
Zicam nasal sprays and breastfeeding
It’s worth noting that the Zicam nasal sprays and swabs may seem like a good idea for the same reason. The product is applied directly to the nasal passages. However, the Zicam® Cold Remedy Nasal Spray and the nasal swabs do not contain zinc. They have homeopathic ingredients.
So the nasal sprays probably have an even lower impact on breast milk than the other products listed below. However, I can’t emphasize enough how little is known about their effectiveness, especially since they are homeopathic.
Zicam lozenges and breastfeeding
The zinc throat lozenges (“Zicam® Cold Remedy Cherry Lozenges”) have zincum gluconicum2x and zincum aceticum2x which ends up being about 8 mg of zinc according to this. This is well below the upper limit of 40 mg, so is also unlikely to negatively impact breast milk.
(Of course each person needs to think about all their zinc sources for the day, including other vitamins and their diet).
The Zicam medicated fruit drops have the same amount of zinc, so also are unlikely to negatively affect breast milk or breastfed infants. And, the quick-dissolve tablets (“Zicam Cold Remedy® Citrus RapidMelts® “) have a bit less zinc. So, a dose of Zicam in these cases is pretty reasonable for most breastfeeding parents.
Some Zicam products also contain a small amount of caffeine, which is often okay for many breastfed babies, but this varies with each individual. See this post for more on caffeine and breastfeeding.
And, some of the products contain additional supplements and natural remedies like elderberry, which is not regulated. Therefore, it’s very difficult to study or to make any general statements about these Zicam products. See this for more on my thoughts on elderberry syrup and children.
What about other cold medications while breastfeeding?
Even though Zicam and some other zinc supplements may be safe enough while breastfeeding, many parents want additional relief. So, what other cold medicines can they consider?
Here are a few very general guidelines. Please make sure to discuss any treatments with your own physician.
- A nasal decongestant like pseuodoephedrine (brand names include Sudafed) may lower milk production. It’s not necessarily dangerous for a baby to drink milk if their mother has had a dose of Sudafed, but the overall milk volume may lower quite a bit. For many (most?) breastfeeding parents, this risk is not worth the relief that these oral systemic decongestants can provide. (By “oral decongestant” I’m referring to a pill or liquid that is swallowed).
- Nasal sprays containing oxymetazoline (brand names include Afrin) are considered low risk with breastfeeding, but should not be used for more than three days due to problematic withdrawal symptoms. So, the use of oxymetazoline may best be an option for a day when cold symptoms are particularly bothersome. Many would consider it a better choice for breastfeeding parents, compared to pseudoephedrine.
- Nasal sprays containing fluticasone (brand names include Flonase, an over the counter medication affiliate link), often used for allergies or stuffy nose associated with seasonal allergies, are considered acceptable with breastfeeding.
- It’s worth mentioning that non-medicated treatments can also bring relief to someone suffering from the common cold. Plain saline nasal spray or a Neti-pot can also provide some congestion relief (affiliate links) with no negative affect on breastfeeding.
Summary: Many Zicam products are reasonable options for some breastfeeding parents.
Thankfully, there’s hope for a breastfeeding mother who wants to take some Zicam products. Occasional use of most Zicam products is usually compatible with breastfeeding. Careful attention should be paid to the non-zinc active ingredients, as well as the ingredients in any other supplements or medications a person may be taking. Zinc may be found in other products and excessive amounts can be unsafe.
That being said, local products like nasal sprays may have even less impact on breast milk.
Maya Mahmood, D.O., F.A.A.P. is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier.