Headaches

Ibuprofen and paracetamol are particularly suitable against headaches in the nursing period, although ibuprofen is often more effective against headaches. Both medications are considered to be safe, since there is already a great deal of experience with their use in pregnancy and breastfeeding and no damage to the child could be shown to have been caused by the mother taking them. In the case of migraine, where permanent medication, e.g. with beta-blockers, is necessary for prophylaxis, the treating physician should be consulted.

There is little experience with nasal sprays with locally effective antihistamines such as azelastine or levocabastine, which are frequently used in the context of hay fever. In principle, both active substances are considered to be harmless during lactation, but transmission through breast milk has not been sufficiently investigated and the possibility of excitation or sedation of the child by the antihistamine cannot be excluded.The same applies to systemically active antihistamines (administered as tablets or infusions) such as loratadine or cetirizine. Locally applied glucocorticoids such as budesonide are considered safe. Cromoglicic acid can also be used safely as a mast cell stabilizer. Systemically effective glucocorticoids such as prednisolone are harmless under short-term high-dose treatment or long-term low-dose therapy, since the amount transferred with breast milk corresponds to only a small proportion of the infant’s own cortisol production.

Sinusitis

Decongestant nasal sprays facilitate nasal breathing and thus ensure a reduction in paranasal sinusitis. Since the sprays are applied locally and only a tiny portion is absorbed and passed on through breast milk, they are well suited for therapy during breastfeeding. Inhalations (e.g. with table salt) have also proven to be effective.

Mucolytics such as ACC (acetylcysteine) can be used just as safely during the breastfeeding period. Paracetamol or ibuprofen can be used as painkillers. Since acute sinusitis usually occurs as part of a viral infection (rhinitis/snuff) of the upper respiratory tract, symptomatic therapy is sufficient. If a bacterial infection is present, the use of antibiotics is necessary. In this case, the doctor must decide individually which remedy is effective against the germ on the one hand and harmless for the infant on the other.