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There's actually a lot that goes into deciding if it is appropriate for that particular mama!
The evidence-based drug information that is available needs to carefully be weighed- general risks and benefits as well as the potential effect on the breastfeeding relationship of this unique mother-baby pair.
What does this mean exactly?
Well, the potential impact on milk supply caused by over-the-counter decongestants might very well be far less of a concern for the mama with a very well-established nursing relationship, who is not pump-dependent, does not work outside of the home where she is separated from her baby for hours on a routine basis, or for the co-sleeping/nighttime nursing duo who greatly benefits from peak prolactin levels with lots of baby-on-breast stimulation. These mamas may experience a slight dip in milk supply or production, but because of frequent and effective nursing, supply rebounds quickly after short-term use.
For other nursing pairs, there may be a greater risk associated with medications and herbs that are known to cause reduction in milk- perhaps we are referring to the mama of a very young newborn and her milk supply is still primarily hormonally driven, or a working mama who doesn't respond optimally to a breast pump, or a mama who has other underlying health conditions that are related to supply concerns.
Nursing dynamics are unique to each and every mama-baby, and so recommendations must always be unique as well.
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