| Drug category | Amount passed to infant in breast milk | Conclusions about maternal use during breastfeeding |
| Intranasal glucocorticoid sprays (budesonide preferred) | Minimal | Compatible. |
| Second-generation oral antihistamines | ||
| Cetirizine | Minimal to small amounts | Large doses or prolonged use may cause sedation in nursing infant. May decrease milk supply if combined with a sympathomimetic. |
| Loratadine | Minimal to small amounts | Compatible but might reduce milk supply if combined with a sympathomimetic, such as pseudoephedrine. |
| Antihistamine nasal sprays | Minimal | Probably compatible. Use intranasal glucocorticoid preferentially. |
| Oral decongestants | ||
| Pseudoephedrine | Passes into milk | Use short-acting preparations only and take just after breastfeeding to minimize amount entering milk. Use intranasal glucocorticoid preferentially for persistent congestion. Use topical vasoconstrictor nasal spray for therapy of less than four days. |
| Phenylephrine | Little information available | Not recommended. |
| Cromolyn nasal spray | Insignificant | Compatible. |
| Leukotriene-receptor antagonists | ||
| Montelukast | Unknown | Use only if other compatible agents are not sufficient and symptoms are significant. Avoid in newborn or preterm infant. |
| Zafirlukast | About 20% | Use only if other compatible agents are not sufficient and symptoms are significant. Avoid in newborn or preterm infant. |
| Ipratropium nasal spray | Unknown; maternal serum levels are negligible and milk levels will be very low, if at all; any drug in milk would not be absorbed by the infant | Probably compatible. |
