What is the treatment for hives during lactation?

Question

Hi doctor,

I have been experiencing chronic hives for eight weeks now, and they are driving me crazy. I started right after my second pregnancy was delivered three months ago and am still breastfeeding. Red welts appear randomly all over the body, especially arms and legs. They itch terribly and leave dark marks when they fade. I tried avoiding common triggers like shellfish, nuts, and new detergents, but could not identify the cause. Antihistamines provide minimal relief and make me drowsy while caring for newborns and toddlers. I am worried it is autoimmune since my thyroid levels were off during pregnancy. Could this be related to hormonal changes or stress from a new baby? What treatments are safe while nursing?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Your ongoing hives, which began three months after delivery, sound incredibly distressing, especially while managing a newborn and a toddler. Chronic hives are often not caused by allergies but can be triggered by hormonal changes, stress, or autoimmune issues. Since your thyroid levels were abnormal during pregnancy, this may be autoimmune urticaria, which can be related to postpartum thyroid dysfunction and hormonal shifts. Stress and sleep deprivation can further worsen symptoms. It is important to get your thyroid function and antibodies tested. In terms of treatment, non-drowsy antihistamines like Loratadine or Cetirizine are generally safe while breastfeeding and can help reduce symptoms. If those are not enough, medications like Famotidine, Montelukast, or even Omalizumab injections (under medical supervision) might be considered. Keeping a symptom diary, avoiding known triggers, and finding ways to manage stress can also be helpful. Consulting an allergist or dermatologist is recommended so you can get more targeted care. With the right support, this condition can be managed effectively.

I hope this information will help you.

Thanks.