Is Sudafed Safe While Breastfeeding?

Dear Ask The Doctor: Hi my name is Jamarius and I'm a Breastfeeding Peer Counselor. I just wanted to know if it is safe for one of my mothers to take Sudafed PE while breastfeeding. She says that she has nothing else to take at the moment and she fears that it will reduce her supply. Is this ok for her to take?

Dear Jamarius: Sudafed contains phenylephrine and is considered safe. While excretion into breast milk is unknown, it is unlikely to be excreted into breast milk in large quantities due to its poor bioavailability. The effect of phenyl­ ephrine on milk production and supply is also unknown; therefore, this medication should be used with caution in women with limited milk production. An alternative would be nasal decongestants which due to their local action and poor systemic absorption are preferred over systemic oral decongestants in breast feeding mothers.