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Using Painkillers While Breastfeeding

from: Karlie Bestler

Many breastfeeding mothers receive well meaning advice from others to stop breastfeeding if they take any medication regularly. According to the American Academy of Pediatrics (AAP), which strongly recommends that infants be breastfed until they are at least 12 months old, that may not be necessary.

Many over the counter medications pass through breast milk in such small amounts that infants aren't significantly affected, according to the AAP. Even prescription painkiller medications may not warrant stopping breastfeeding. You should always check with your doctor before taking any medication while breastfeeding.

Here's a description of various analgesics, along with guidelines for which drugs are considered safe during breastfeeding and which should be avoided.

Over the counter painkillers come in two categories, based on their active ingredients:

Acetaminophen

Acetaminophen is the active ingredient in Tylenol. Acetaminophen is generally considered safe in pregnancy and has been well researched. Acetaminophen is used primarily for headaches, fever, aches, pains and sore throat.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin as well as Advil or Motrin (ibuprofen) and Aleve (naproxen). Aspirin should be avoided by breastfeeding mothers because its blood thinning properties can cause rashes or bleeding abnormalities in breastfed infants.
Ibuprofen and naproxen, however, are considered safe for breastfeeding mothers and breastfeeding babies. So for mothers breastfeeding and naproxen and ibuprofen are usually considered safe medications while breastfeeding.

Prescription Painkillers

Prescription painkillers are typically used for intense pain resulting from injuries, surgery, dental work or migraine headaches.

Prescription analgesics include codeine (obtainable in low doses behind pharmacy counters without a prescription), OxyContin (morphine) or Percocet (oxycodone and acetaminophen), Demerol (meperidine), Duragesic (fentanyl), and Vicodin (hydrocodone). Doctors allow their use sporadically in breastfeeding mothers when the benefits clearly outweigh the potential risks to breastfeeding babies.

Codeine is frequently used in combination with acetaminophen as a painkiller or cough suppressant, but some breastfeeding mothers, especially those of North African, Ethiopian and Saudi Arabian descent, metabolize codeine more rapidly than others, which could lead to a potentially lethal drug buildup of morphine (codeine metabolizes into morphine in the body) in their breastfeeding babies. Doctors may want to screen some mothers for this predisposition if prescribing codeine.

For all narcotics, the risks to nursing infants include excessive drowsiness, difficulty breathing and poor breastfeeding. Regular use of opioids by breastfeeding mothers is not advised.

Breastfeeding mothers should always tell any physician or dentist if they are breastfeeding. Sometimes a physician or dentist will prescribe something without realizing or asking if the mother is breastfeeding. Breastfeeding mothers need to take extra care to only use safe medications while breastfeeding.