Can You Take Sudafed While Breastfeeding - And Will it Impact Milk Supply?
When you’re a breastfeeding mom and you come down with congestion, you just want to feel normal again. I’ve been there. But the big question I hear all the time is: “Can I take Sudafed while breastfeeding?” And if I can, “Will it hurt my supply?”
Let’s walk through what the research says, what I see in real life with breastfeeding moms, and what you should keep an eye on.
Can You Take Sudafed While Breastfeeding - And Will it Impact Milk Supply?
Decongestants and Breastfeeding
Sudafed is one of the most common over-the-counter medications moms reach for when dealing with a stuffy nose. But when you’re breastfeeding, you might pause a little more and wonder if it’s safe for your baby - or for your milk supply.
Some medications are very breastfeeding-friendly. Others are safe for the baby but may affect the amount of milk you make. Sudafed falls into that second category. Before choosing a decongestant, it’s helpful to know the pros and cons so you can make the best choice for your body and your breastfeeding goals.
As always, it’s smart to check with your healthcare provider before you start any new medication while nursing. You can work with my team of expert lactation consultants virtually to help you navigate situations like this with ease.
Bottom line - is it safe to take Sudafed while breastfeeding or not?
Sudafed does pass into breast milk, but usually in small amounts. For most babies, Sudafed is considered generally safe for short-term use. A few babies may get irritable or have trouble sleeping.
The bigger concern is milk supply. Sudafed can cause a noticeable decrease in the amount of milk you make - sometimes more than moms expect. If maintaining supply is important to you, this may not be the best choice. I actually frequently recommend sudafed for mothers who are wanting to decrease supply.
Throughout this article, we'll dive more into the potential risks and alternative medications. If you are currently pregnant, here is some great information on this topic - Can You Take Sudafed While Pregnant?
What is Sudafed, and what are its uses?
Sudafed contains pseudoephedrine, a decongestant used to:
reduce sinus pressure
shrink swollen nasal passages
relieve congestion from colds, sinus infections, and allergies
You can find it in tablets, capsules, liquids, and sometimes mixed with other cold medications.
Is Sudafed Safe for Breastfeeding Mothers and Babies
Pseudoephedrine is rated an L3 for breastfeeding, which means it is “moderately safe.” It does transfer into milk, but typically not at levels that harm a baby.
The main risk is to your milk supply, not to your baby.
The InfantRisk Center (the best evidence-based resource we have) explains that Sudafed can reduce milk production—especially in moms who:
already struggle with supply
are more than 6 months postpartum
have recently returned to their menstrual cycle
are producing a lower amount of milk to begin with
This is why I recommend approaching Sudafed cautiously.
Does Sudafed impact milk supply?
Yes, it can.
In one study, breastfeeding women who took a single 60 mg dose of Sudafed experienced an average 24% drop in milk production over the next 24 hours. That’s a big dip for many moms.
As I mentioned, Sudafed is actually something I sometimes recommend when someone wants to dry up their supply or reduce oversupply. That tells you how powerful the effect can be.
Things that may make a Sudafed-related supply drop worse:
being farther postpartum
recent hormonal shifts
already nursing less frequently
starting to pump instead of directly breastfeed
If you’re still building your supply or you’ve struggled in the past, I would avoid Sudafed if you can.
What are the side effects of Sudafed for Mom?
Most side effects are mild but can still make parenting while sick feel harder. Watch for:
restlessness or jitters
trouble sleeping
dizziness or lightheadedness
headache
nausea
increased heart rate
sweating
feeling shaky
If anything feels “off,” don’t hesitate to reach out to your provider.
Side Effects to Watch For in Baby
Because small amounts pass into milk, keep an eye on your little one for:
irritability
difficulty sleeping
feeding changes
tremors
unusual fussiness
poor weight gain (rare, but possible if your baby nurses less)
If anything concerns you, reach out to your pediatrician.
Tips for Taking Sudafed while Breastfeeding
If you’ve talked to your provider and decide you still want or need to take Sudafed, here are a few ways to reduce the risk of supply issues:
Use the lowest effective dose for the shortest time.
Take it right after a feeding or pump session so there’s more time before your next milk removal.
Stay hydrated and support electrolytes. Sudafed can be dehydrating, and dehydration alone can reduce your amount of milk. I recommend upping your electrolytes while you are taking Sudafed.
Watch your baby closely for side effects.
Pay attention to your supply. If you notice a dip, stop Sudafed as soon as possible.
Have a backup plan - especially if your baby is under one and relies heavily on breast milk.
Are Nasal Spray Decongestants Safe While Breastfeeding?
Often, yes, and many are much better choices than Sudafed when you're trying to protect your supply.
Safer options typically include:
Oxymetazoline (like Afrin) – short-term use only
Phenylephrine (in nasal spray form) – but avoid oral versions due to poor effectiveness
Corticosteroid nasal sprays (Flonase, Nasacort) – great long-term allergy options
Cromolyn sodium (NasalCrom) – another safe choice
These medications stay more local to the nasal passages and have less impact on milk supply.
Natural Alternatives for Treating Congestion While Breastfeeding
If you’d rather avoid Sudafed completely, here are options I often recommend to my clients:
Saline spray or saline rinses (this is my personal favorite brand)
Steam from a shower or humidifier
Elevating your head at night
Hydration and electrolytes
Warm compresses over sinuses
Vitamin C for immune support
Peppermint oil in a diffuser (just avoid applying peppermint directly to skin while breastfeeding or ingesting it)
These techniques won’t hurt your supply and can offer real relief.
Is it safe to breastfeed while sick?
Yes, almost always.
Your baby actually receives antibodies through your milk that help protect them from getting sick. You do not need to pump and dump.
Just practice handwashing, good hygiene, and rest as much as you can.
Sudafed can be helpful for relieving congestion, but it’s not always the best choice if you’re breastfeeding, especially if you’re still working hard to protect your supply. It’s usually safe for babies, but it can decrease your amount of milk, sometimes more than expected.
If you decide to take it, be mindful, stay hydrated, and monitor both your supply and your baby’s behavior.
And if you're ever unsure, please reach out. As an IBCLC, I’m here to help you feel confident!
