I’m Breastfeeding: Can I Take Sudafed?

Medically reviewed by Zara Risoldi Cochrane, PharmD, MS, FASCP on July 12, 2016Written by University of Illinois-Chicago, Drug Information Group on July 12, 2016

Introduction

You’re breastfeeding and congested, so you’re wondering—is it safe to take Sudafed? Sudafed is a decongestant that contains the drug pseudoephedrine. It helps treat nasal stuffiness, congestion, and pressure related to allergies and the common cold. It does this by shrinking the swollen blood vessels in your nose and sinuses. But how will Sudafed affect your child?

Here’s what you need to know about Sudafed and relieving your congestion while taking the best care of your little one.

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.

But there are other factors to consider about using Sudafed while breastfeeding. For instance, one report claims that Sudafed may cause infants to be more irritable or more lethargic than normal.

Also, Sudafed may reduce the amount of milk your body makes. One small study showed that over a 24-hour period, Sudafed decreased the women’s milk production by 24 percent. If you take Sudafed while breastfeeding, you should monitor how much milk your body makes. Drinking extra fluids may help increase the amount of milk you produce.

All forms of Sudafed contain pseudoephedrine, the drug that causes the effects described above. However, Sudafed 12 Hour Pressure + Pain also contains the drug naproxen sodium. This drug can help relieve pain and treat fevers. According to the National Institutes of Health, naproxen sodium is thought to be generally safe for use while breastfeeding. However, if you’re breastfeeding a newborn or preterm infant, you should likely use an alternative.

Tips and alternatives

If you’re concerned about using Sudafed while breastfeeding, consider these tips and alternative options. They can help you reduce or avoid effects on your child.

Tips

Avoid using Sudafed products that are called “extra strength,” “maximum strength,” or “long-acting.” These products may stay in your system longer and increase any effects on your child.

When possible, avoid breastfeeding within two hours of your last dose of Sudafed. You have the highest amount of Sudafed in your breast milk one to two hours after you take the drug. Avoiding breastfeeding during that time can help keep higher levels of Sudafed from entering your child’s system through your breast milk.

Alternatives

Drugs that come as a nasal spray or rinse may be safer options than forms you take by mouth. This is because nasal forms generally work directly in the nose and send less of the drug into your breast milk. Some examples include:

  • phenylephrine nasal drops or sprays, available as generic drugs or the brand-name drug Neo-Synephrine
  • oxymetazoline nasal spray, available as Afrin, Zicam Intense Sinus Relief, or other drugs

If you’re looking for other options, talk with your doctor about whether another drug may work better for you.

Several methods can help relieve congestion without the use of medication. For instance, using a humidifier or taking a shower both provide steam, which can help open up your nasal passages. Saline sprays, which you can find over-the-counter at your local drugstore, can help empty fluids from your nose. These salt-and-water formulas can also decrease pressure in your nasal passages. At night, you can try adhesive nasal strips. These strips help open your nasal passages to help you breathe more easily while you sleep.

Keep reading: How to clear a stuffy nose »

Side effects

When deciding whether to use the drug while breastfeeding, you should also consider the side effects you may have from Sudafed. The more common side effects you might have while taking this medication can include:

  • stomach pain
  • anxiety or restlessness
  • dizziness
  • headache
  • nausea
  • sensitivity to light

More serious but rare side effects from Sudafed can include:

  • rash
  • seizures
  • hallucinations (seeing or hearing things that aren’t there) or psychosis (mental changes that cause you to lose touch with reality)
  • heart problems, such as chest pain, increased blood pressure, and irregular heartbeat
  • heart attack or stroke

Talk with your doctor

When considering Sudafed, be sure to consider all factors. These include the benefits of breastfeeding and the risk to your child of effects from Sudafed. You should also consider the risk of not properly treating your nasal congestion. You may want to talk with your doctor before taking Sudafed while breastfeeding. They know your medical history and can answer your specific questions. Some questions you may ask include:

  • What non-drug options are there for relieving my congestion?
  • Based on my current symptoms, what type of medication should I use?
  • Is there anything I can do to prevent congestion so that I won’t need to take medication?

Your doctor can help you decide on the best treatment to help relieve your congestion while breastfeeding to keep your child safe.

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