I’m a nursing day-care mom who just recovered from (yet another!) sinus cold, without the help of decongestants or cough meds, for the safety of my baby and my milk supply. Is there a reason from your/the data’s POV as to why better breastfeeding-safe drugs aren’t on the market? Modern medicine is capable of so much, and I get frustrated thinking it’s in part because women’s health issues aren’t often prioritized. What can we do to help bring about a change?—Ibuprofen Ain’t Cutting It
This question actually gets at two deep problems with how we address women’s health.
The first issue is that we haven’t given people (including, maybe, you) the opportunity to see the data you’d need to think about whether it makes sense to take a decongestant. This careful paper is my favorite on the topic. The authors had eight breastfeeding women take a dose of pseudoephedrine (basically, Sudafed). They measured two things. First, milk volume. Second, the amount of medication in the milk.
On average, milk volume declined 25% in the 24 hours after the dosage. This varied considerably across people, with some showing virtually no decline and others a larger one. Note that this is a short-term measure — the impact is thought to be during the dosing, not in the long term.
In terms of medication in milk, the amounts measured, even after the maximum dose, were extremely small — about 3% of the recommended dose for treating slightly older children. This suggests that there isn’t a significant safety concern.
All of that is to say: depending on your milk supply situation and your baby’s age, it seems very possible you might want to use this information to consider digging into the medication when you get the next inevitable cold.
The second issue is, of course, that there isn’t enough research on women’s health. This includes the need for more research on these questions of safety for the drugs we have but also research on drugs that might be used as an alternative. We have a long way to go in this domain.