Can I take it while breastfeeding?

Photo credit: https://www.flickr.com/photos/22990055@N06/

There's a laundry list of medications, hormonal birth control, herbs, and supplements which are generally advised against because of the potential negative impact on breast milk supply. Decongestants are widely known to have this effect. And being that it IS cold and flu season right now it's definitely not uncommon to see a mama, suffering in her head cold wallows, to post in an online forum: "Help! I'm breastfeeding. Is it safe to take_____?"

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.

What really worries us about informal milk sharing- and it's not what you'd think!

We have to start off by saying that we unequivocally recommend breast milk. As they say, "human milk for human babies"- it just makes sense. If a mama's own milk isn't available, donor milk from another mama is the very next best thing, and yes it's better than formula. The debate in the lactation consultant world tends to be over "informal" versus "formal" milk sharing. Formal being through an official milk bank (which blends, pasteurizes, and homogenizes... making breast milk prohibitively expensive and turning women's efforts into big business profits).

Informal milk sharing is everything else.

It's manually expressing colostrum for a friend's toddler who keeps getting sick in daycare. It's giving half of your frozen pumped stash to a mom who is going back to work and doesn't have milk saved. It's food for babies who can't tolerate artificial formula but never latched on to their mother's breast. It's cross-nursing and wet-nursing, and yes, both of those things really happen!


Informal milk sharing has some risks, and moms should be and are generally aware of them. An improper donor could pass along a disease, could have incorrectly stored the milk, or could be taking drugs. All of these reasons are why milk sharing communities widely discourage purchasing breast milk. Freely giving milk is a time consuming process, and is a labor of love. The World Health Organization recommends milk from a "healthy donor", yet some lactation consultants will universally discourage milk sharing unless the mothers are participating in the formal milk bank system because of those (admittedly rare) risks.

What really worries us about informal milk sharing is not any of those things. It's what may be happening behind all of that beautiful sharing for both the donor and the recipient. Are they getting the support that they need?

Mamas who have hundreds and thousands of bags of milk frozen may be pumping like crazy because they are suffering with an oversupply problem. They are at risk of mastitis and plugged ducts if they were to suddenly stop pumping, and may not know how to get out of this situation. Or they might not be feeding their milk to their own baby because he or she has symptoms of intestinal distress and their pediatrician or GI specialist has advised them to stop nursing and switch to a specialty formula. These women need support.

Mamas who are supplementing with donor milk may have a baby who never latched. Or they struggled with low milk supply. Or they are returning to work and don't have the appropriate tools and support in place to provide milk for their baby.

All of those things can be compounded by the continuation of the milk sharing cycle, because supplementing with breastmilk is still supplementing and still reduces supply. It can throw the whole system out of balance. The best thing women can do when they are milk sharing is to contact a lactation professional and talk over whatever concerns they might be having. And if the lactation professional gives them a lecture about the dangers of milk sharing instead of lending an ear and offering real support, we hope they have the courage to pick up the phone one more time and call someone else. 

The Fourth Trimester  is honored to be your advocate!

Call us for a free breastfeeding phone consultation-

 Gladis- 727-657-7370     Emily- 727-452-4809

Email- fourthtri@gmail.com

www.TheFourthTrimester.net

Photo courtesy of Aurimas!