I had a yucky cold last week. I was fine during the day using the usual home remedies, but one night I really wanted to be able to sleep well. So I looked in our medicine cabinet to see what we had.
Yes, yes, I know that taking a cold medicine doesn't shorten the duration of a cold, but I don't think it's a crime to want some relief from the symptoms, especially when trying to take care of small chidren.
I've always cautioned moms against taking pseudoephedrine while nursing, but I wanted a refresher in the concern about it, and what I could take. So I consulted Dr. Thomas Hale's Medications and Mothers' Milk, 2010.
(If you want the same information I have in this gem of a book - for free - you can call the Dr. Hale's Infant Risk Center!)
Here's what Dr. Hale says about pseudoephedrine's effect on milk supply:
In a study of eight lactating women who received a single 60 mg dose of pseudoephedrine, the 24 hour milk production was reduced by 24%...While these results are preliminary, it is apparent that mothers in late-stage lactation may be more sensitive to pseudoephedrine and have greater loss in milk production.
Medications and Mothers' Milk has an appendix devoted to over-the-counter cold remedies, and for each of the many cold medicines which contain pseudoephedrine Dr. Hale has written "Probably safe, may suppress milk supply."
I should note that nearly all of the cold medicines listed had mulitple ingredients, and there may be other concerns related to those medicines. For example, for many products Dr. Hale has written "observe for sedation" (in the baby, that is). In a handful of cases he lists medications as "unsafe." The vast majority are listed as "probably safe," and two lonely products are listed as "safe." Again, if you have questions or concerns about a medication you want to take, call the Infant Risk Center.
Rumaging through our supplies, I found some cold medicine which had no pseudoephedrine but had phenylephrine (a decongestant). I checked that, too, and read Dr Hale's assessment: "Because of pseudoephedrine's effect on milk production, concerns that phenylephrine may supporss milk production [sic], have not been confirmed yet. There is no evidence that this occurs at all." He does not list "may suppress milk supply" in the Appendix for products containing this ingredient.
I generally ascribe to the precautionary principle when it comes to these things, but I was pretty desperate for a good night's sleep. So, I decided to take an informed risk and use the product with phenylephrine, one time. And it did help make it through the night. I have a strong milk supply, and I didn't notice any dimunition.
I hope that you all make it through cold season in one piece, and that you take advantage of the Infant Risk Center for medication questions!
* This post is provided for educational purposes only. Please consult your health care provider for care related to this topic.
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