Is Doxylamine Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Doxylamine? Is Doxylamine safe for nursing mother and child? Does Doxylamine extracts into breast milk? Does Doxylamine has any long term or short term side effects on infants? Can Doxylamine influence milk supply or can Doxylamine decrease milk supply in lactating mothers?

• DrLact safety Score for Doxylamine is 5 out of 8 which is considered Unsafe as per our analyses.
• A safety Score of 5 indicates that usage of Doxylamine may cause serious side effects in breastfed baby.
• Our study of different scientific research indicates that Doxylamine may cause moderate to high side effects or may affect milk supply in lactating mother.
• Our suggestion is to use safer alternate options rather than using Doxylamine .
• It is recommended to evaluate the advantage of not breastfeeding while using Doxylamine Vs not using Doxylamine And continue breastfeeding.
• While using Doxylamine Its must to monitor child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
• Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

It is a first generation antihistamine drug which is related to ethanolamine, with sedative and anti-muscarinic effects. It has been used as hypnotic and for vomiting relief. At latest update, relevant published data on excretion into breast milk were not found. Pharmacokinetic characteristics would favour that it may be excreted into breast milk in significant amount. On a telephone survey, 10% of infants whose mothers were on several types of antihistamine medication have suffered of colicky pain and irritability that disappeared without treatment. For both treatment of mothers and infants would be safer the use of tested antihistamine medication without sedative effect, especially in prematures and infants younger than 1 month of age. Whenever used while breastfeeding, the use of the lower effective dose and for the shortest time as possible is recommended. Follow-up for somnolence and feeding troubles should be warranted. Bed-sharing is not recommended when the mother is on this medication.

Small occasional doses of doxylamine would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use may cause drowsiness and other effects in the infant or decrease the milk supply, particularly in combination with a sympathomimetic such as pseudoephedrine or before lactation is well established.

Relevant published information on doxylamine was not found as of the revision date. In one telephone follow-up study, mothers reported irritability and colicky symptoms 10% of infants exposed to various antihistamines and drowsiness was reported in 1.6% of infants. None of the reactions required medical attention.[1]

Antihistamines in relatively high doses given by injection can decrease basal serum prolactin in nonlactating women and in early postpartum women.[2][3] However, suckling-induced prolactin secretion is not affected by antihistamine pretreatment of postpartum mothers.[2] Whether lower oral doses of antihistamines have the same effect on serum prolactin or whether the effects on prolactin have any consequences on breastfeeding success have not been studied. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.