Breastfeeding & Pain Medications

A breastfeeding mother needs to be concerned about what she eats, drinks or is exposed to, since many things can pass into breast milk and then into her nursing infant's system. While there are some general guidelines for medications and the nursing mother, it's always important to check with a health provider before taking any medication.

After Delivery

It's a good idea for expectant mothers to speak with their physicians prior to giving birth about the plan for labor and delivery. If a woman knows in advance that she is having a Cesarean delivery and she plans to breastfeed, she needs to discuss the impact of medications used during the procedure as well as post-operative medications. The anethesiologist can use medications that will ease post-operative pain while allowing the mother to be alert (see reference 4). Also, pregnant women should discuss the impact of any other medications used during a vaginal birth on breastfeeding. However, most medications will not interfere with nursing a baby.

Narcotics

Particularly during or immediately following birth narcotic analgesics or pain medications such as demerol, codeine and morphine may be prescribed to nursing mothers. According to Dr. Jim Sears, of the television program The Doctors, and from the website Askdrsears.com, morphine has the least effect on breastfeeding infants. Medications containing codeine have a riskier profile, with reports of breathing difficulties in newborn infants when mothers received the drugs after delivery. Demerol injections for the mother can make a baby sleepy and less eager to nurse. Short-term use is typically not problematic, but long-term exposure to such drugs would be considered unsafe.

OTC Pain Medications

Over-the-counter pain medications such as Tylenol or acetaminophen are considered the safest medication for pain and fever relief, since only a very small amount crosses over into the breast milk. Tylenol is generally considered safe during pregnancy as well. Ibuprofen. which isn't typically administered to pregnant women, is considered safe for nursing mothers (see Reference 1). It's a good rule of thumb, according to the March of Dimes, that any medication allowed pregnant women would be allowed for breastfeeding mothers as well.

Risk/Benefit Ratio

With breastfeeding mothers it's important to evaluate the risks and benefits of taking any medication. However, pain will interfere with a nursing mother's ability to produce milk. If avoiding the medication will hasten weaning, it's definitely in the infant's best interests for a mother to continue nursing and for the mother to obtain adequate pain relief (see Reference 4).

Considerations

According to the March of Dimes, to be extra safe, breastfeeding mothers should avoid the extra-strength formulas of any medication. To minimize the amount of medicine a baby receives, breastfeeding should be timed so that the mother takes the medicine either right after a nursing session or at least a few hours prior to nursing. In the case of a long-acting medicine, they recommend taking the medicine after breastfeeding and before the baby's longest sleep time to give the medicine the most time to clear from the mother's body while the baby is sleeping. If a nursing mother notices any possible side-effects from medicine she is taking, she should consult a physician or pharmacist.