You woke up very congested, with a stuffy nose and terrible sinus pressure. It’s hard to breathe, hard to think, and on top of that, you have a little one to tend to. Normally, you would reach for a decongestant like Sudafed for some relief, but you’re breastfeeding, and you’re not sure if it’s an acceptable option.
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.
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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.
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Sudafed While Breastfeeding
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.
Every breastfeeding journey is different. Be sure to consult with a healthcare provider about your circumstances if you have any questions about taking Sudafed while breastfeeding.
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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.
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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.
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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.
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.
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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.
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Effects of Sudafed when breastfeeding
Sudafed does pass into breast milk. According to the American Academy of Pediatrics, it's still likely safe to take Sudafed while breastfeeding, though. The risks to a child who is breastfed are thought to be low.
Pseudoephedrine is secreted into breastmilk in low levels. In one study (Findlay 1984) the calculated dose that would be absorbed by the infant was very low (0.4 to 0.6% of the maternal dose). However in a study of 8 women a single 60 mg dose of pseudoephedrine reduced milk supply by 24% over a 24 hour period.Does Sudafed hurt milk supply? ›
Risks of Sudafed While Breastfeeding
“A single dose of pseudoephedrine significantly reduced milk production,” the study researchers concluded. 5 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.
Pseudoephedrine, or Sudafed, is a common over-the-counter decongestant. Research shows the Sudafed causes a noticeable decrease in milk production. Like birth control, Sudafed should only be used to suppress lactation under the supervision of a doctor.Which Sudafed to stop breastfeeding? ›
In a small study in 2003 of 8 lactating women, a single 60-milligram (mg) dose of the cold medicine pseudoephedrine (Sudafed) was shown to significantly reduce milk production.What decongestant can a nursing mother take? ›
Pseudoephedrine and phenylephedrine are oral decongestants for treating nasal congestion caused by colds, allergies, and sinus infections. Both ingredients are common in over-the-counter medications and considered safe while breast-feeding.Can you take Sudafed or mucinex while breastfeeding? ›
Decongestants that are taken by mouth, such as pseudoephedrine (Sudafed), are not likely to be harmful to a breastfed infant, but may lessen the amount of breast milk that you make. If you have nasal congestion, talk with your healthcare provider about treatment.Will decongestant decrease milk supply? ›
Decongestants. Both pseudoephedrine and phenylephrine are generally considered to be safe for the breastfed baby, but pseudoephedrine may reduce milk supply.What medication can I take to dry up my breast milk? ›
Taking drugs such as Cabergoline or Dostinex® to stop breast milk works best for mothers who have not been breastfeeding for long. Talk to your doctor, midwife or nurse if you would like more information about these drugs.What medication dries up milk supply? ›
Drugs such as cabergoline and bromocriptine reduce prolactin levels , helping dry up breast milk supply.
The decongestants that you take by mouth — like pseudoephedrine (Sudafed) or phenylephrine PE (Sudafed PE) — pose little risk for babies, but could reduce your milk supply. This milk supply reduction doesn't always happen, but it could.Does Sudafed dry up drainage? ›
Known by the brand name Sudafed, it is a drug classified as a nasal decongestant. These drugs stop a runny nose and dry up your sinuses. Pseudoephedrine only treats symptoms caused by a common cold, sinusitis, allergies, and similar conditions. It is not a cure for viral or bacterial illness.Will ice packs dry up my milk? ›
After pumping, use ice packs, gel packs or a package of frozen peas on each breast for 5–15 minutes at a time. To avoid freezing the skin, lay a thin towel over your breasts and lay the ice pack on the towel. The ice will help decrease milk production.Can breast milk come back after drying up? ›
It's called re-lactation. It's possible for the female body to come back from “drying up” and produce milk again. In fact, many mothers of adopted children are able to pump and use several methods in order to stimulate their bodies to produce milk, even if they haven't given birth!What dries up breast milk fast? ›
Pseudoephedrine (Sudafed) can help dry up your milk, but ask your doctor before using this medicine, and do not take it if you have problems with your kidneys, thyroid or have glaucoma. Take Benadryl as directed on the package. If you plan to resume birth control pills, ask your doctor for pills that contain estrogen.How much Sudafed does it take to dry up milk? ›
One small study of eight women showed that just one dose of pseudoephedrine (60 mg) lowered breast milk production.How long does it take for breast milk to replenish? ›
The first few days: Your breast milk coming in
Around day three after your baby's birth, your breast milk 'comes in' and your breasts may start to feel noticeably firmer and fuller.
- Not producing enough wet/dirty diapers each day. Especially in the first few weeks of life, the number of wet and dirty diapers your child produces is an indicator of the amount of food they're getting. ...
- Lack of weight gain. ...
- Signs of dehydration.
If a nasal decongestant spray is a fixture in your medication lineup, it's important to know that using these sprays for more than three consecutive days can actually worsen your congestion. "This side effect of nasal decongestant sprays is called rebound congestion," says Dr.Does blowing nose make congestion worse? ›
But in a new study, they have found that doing so may actually make a cold worse, because the blow propels mucus into the nasal sinuses. Blowing one's nose creates a significant amount of pressure, according to Jack M.
- Drink plenty of water. ...
- Eat foods with antibacterial properties. ...
- Add moisture. ...
- Clear the sinuses with oils. ...
- Use a neti pot. ...
- Ease facial pain with warm compresses. ...
- Use over-the-counter (OTC) medications. ...
- Get a prescription.