Unfortunately, while Sudafed (pseudoephedrine) is unlikely to harm your baby, it can significantly lower your milk supply, which is why most experts recommend that you don’t take Sudafed while breastfeeding. “In general, healthcare providers do not recommend Sudafed use when breast/body feeding,” says Sarah Shealy, IBCLC, a professor of nursing, and certified nurse-midwife. “The primary concern with Sudafed is the effect it has on milk supply.” Let’s take a deeper look into taking Sudafed while breastfeeding, the way it affects milk supply, and what alternative medications and remedies may be an option for you.
What Is Sudafed?
The active ingredient in Sudafed is pseudoephedrine, a decongestant. Decongestants relieve the pressure you feel in your nasal passages when you have a cold or allergies. Pseudoephedrine narrows the blood vessels in your nasal passages, which helps decrease the feeling of pressure. Sudafed doesn’t cure the underlying condition that is causing this pressure (viruses or allergies, for example) but offers symptom relief. Sudafed is taken in tablet or liquid form. There are different types of Sudafed, some that are taken every 4-6 hours for relief, and some that are longer acting. You should read the instructions carefully before taking any medication, including Sudafed. Before taking Sudafed, you should discuss any medications, supplements, or recreational substances you are taking with your healthcare provider, as some should not be taken with Sudafed. You should also discuss any medical conditions you may have. Sudafed should not be taken at all by children under the age of four. If you are planning to give Sudafed to an older child, you should discuss this with their pediatrician, as correct dosage is important.
How Does Sudafed Affect Breastmilk?
The overall consensus is that taking Sudafed while breastfeeding is not dangerous for babies, but it can significantly decrease your milk supply. This is why Sudafed is not recommended while breastfeeding unless your goal is to decrease your milk supply. According to Lactmed, a government-sponsored database that compiles information about medications and breastfeeding, Sudafed is unlikely to harm your baby. Small amounts of it do pass into your breastmilk, but there are no serious known health risks to your baby. Yvonne Bohn, MD, OBGYN at Providence Saint John’s Health Center in Santa Monica, CA, agrees that the risks to your baby are minimal. “After an adult prescription dose of Sudafed, which is 60 mg, a fraction of it is transmitted to the breast milk,” she explains. Dr. Bohn notes that there are some minimal side effects that have been seen in babies whose breastfeeding parent has taken Sudafed, citing research that showed increased irritability in babies. However, the impact that Sudafed can have on milk supply can be substantial. “Both research and anecdotal evidence point to Sudafed as a threat to milk supply,” Shealy says. “Essentially the same mechanism that makes Sudafed clear up your congested nose will also dry up your milk supply.” Shealy says that there is no real benefit to taking Sudafed while breastfeeding and that the risks to your milk supply—and your breastfeeding relationship with your baby—are too high. That’s why she recommends finding alternatives to Sudafed if you find yourself dealing with congestion or sinus pressure.
Risks of Sudafed While Breastfeeding
Again, the main risk to taking Sudafed while breastfeeding is that it can drastically decrease your milk supply. In fact, some lactation consultants and breastfeeding doctors recommend Sudafed, or other pseudoephedrine products, in cases of hyperlactation, or excessive oversupply. Using pseudoephedrine to manage hyperlactation is something that the Academy of Breastfeeding Medicine recommends. The evidence that Sudafed can decrease milk supply is strong. A study published in the British Journal of Clinical Pharmacology found that taking the recommended dose of Sudafed (60 mg) decreased milk supply by 24% in a 24 hour period. “A single dose of pseudoephedrine significantly reduced milk production,” the study researchers concluded. The exact mechanism for how this happens is not clear, they explain. The drop in milk supply is not because of changes in blood flow to the breast, for example. Either way, the researchers conclude that this drop in supply is noteworthy. As Shealy points out, such significant drops in milk supply are a risk to your baby. Your baby may not get enough nutrition during this time, and while discontinuing the medication should help your milk supply rebound, dealing with a noticeable milk supply drop like that can be very stressful for a breastfeeding parent.
When Can I Resume Using Sudafed?
If you want to avoid decreases in your milk supply, it’s best to refrain from taking Sudafed, or any product containing pseudoephedrine, until you are done breastfeeding. Once you are ready to start taking Sudafed again, make sure to check in with your doctor for clearance, especially if you have any medical conditions, or if you may be pregnant or are considering becoming pregnant.
Breastfeeding Safe Alternatives
Although taking Sudafed while breastfeeding is not recommended, there are still ways to relieve congestion, sinus pressure, and other cold and allergy symptoms. And you definitely deserve some relief! Here are some breastfeeding-friendly options to consider.
Alternative Medications and Nasal Sprays
Erika Gray, PharmD, chief medical officer and co-founder of Toolbox Genomics, says that using medicated nasal drops or sprays can offer relief and should not impact your milk supply. “Alternatives that work directly in the nose and send less drug into the breast milk include phenylephrine nasal drops or sprays or oxymetazoline nasal sprays,” she offers. Dr. Bohn notes that nasal washings, topic nasal sprays, and Benadryl are all alternatives to Sudafed that should not cause any issues with breastfeeding.
At-Home Remedies
There are several at-home remedies and natural methods you can try to relieve your congestion and sinus pressure. Gray suggests running a humidifier, using steam treatments to relieve congestion, and trying a Neti pot to clear your nasal passageways. Shealy recommends prioritizing rest and increasing fluids at the first sign of a cold so that you can recover faster. This can be easier said than done when you are caring for a baby, but you can let the cleaning and chores go for a few days as you recover, and try to use your baby’s naptime to get some extra rest. Sipping hot tea and drinking hot soup can also help clear your nasal passageways and offer some much-needed relief, Shealy suggests.
Boost Your Immune System
Gray recommends making sure your immune system is in good shape so that you can avoid colds in the first place or fight them faster when you do get them. One way to do this is to make sure you are getting adequate Vitamin D, and take a supplement if necessary, Gray advises. Other breastfeeding-safe ways to boost your immune system include having a well-balanced diet rich in fruits and vegetables. Taking vitamins and supplements known to strengthen your immune system are also options. Speak to a healthcare provider about the best immune-boosting supplements for you.
A Word From Verywell
Dealing with nasal congestion from a cold or allergies is the worst! It can make your life downright miserable and very uncomfortable. And there is nothing more exhausting than being sick and having to parent at the same time. If Sudafed has always been your medication of choice when dealing with congestion, you may feel frustrated to learn that it’s best to refrain from taking it while breastfeeding. Still, it’s best to do so because of the fact that Sudafed can lower your milk supply. Luckily, there are several good alternatives to taking Sudafed that should help relieve some of your symptoms. If you have any questions about taking Sudafed while breastfeeding, or what other options are available to you, don’t hesitate to reach out to a healthcare provider.
