i suffered from really bad sinus issues during my 1st trimester and now they've come back in the 3rd. one sinus headache was bad enough and last for over 3 days that i took myself to the er, i was at my wits end. the er doc recommended sudafed, used sparingly, alongside a nasal spray. sudafed in the morning, nasal spray at night. i react bad to sudafed so i only took one pill at a time/day, enough to take the edge off. when i had my first appointment with my midwife i discussed this, among other things (caffiene, sushi, etc.) with her. her response was to do things in moderation. a lot of women do a far worse things during their pregnancy that take some sudafed, drink soda, or enjoy a salmon roll. the interwebz is ripe for conflicting information, you'll never find the information you're looking for. in the end, i trust the recommendation of the er doc, who shared that she suffered from the sinusitis as well. and i trust the common sense approach of my midwife.
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i suppose in the end, the answer is moderation is the key.