1. Health

Taking Painkillers While Breastfeeding: What's Safe and What's Not?

A Guide to Taking Painkillers While Breastfeeding

By Maureen Salamon

Updated February 26, 2009

(LifeWire) - Nursing mothers tend to have such busy lives that nothing -- not even pain from a throbbing headache or a lingering injury -- can slow them down. Fortunately, taking painkillers while breastfeeding can be done safely, although the right medication and careful monitoring are necessary to ensure the baby's safety.

Pain medications, also known as analgesics, can be either over-the-counter (OTC) or prescription strength. The latter are more potent than the OTC versions, but they also present more potential dangers to a nursing baby. OTC analgesics, however, are not risk-free either. Some drugs in both categories can cause health problems in newborns and even life-threatening complications.

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

According to the US Centers for Disease Control, about 74% of new babies in 2005 were breastfed for some period of time; about 43% were still nursing at 6 months old and 21% at 1 year.

Many OTC medications pass through breast milk in such small amounts that infants aren't significantly affected, according to the AAP, and even prescription painkiller use may not warrant severing the nursing relationship.

Here's a description of various analgesics, along with guidelines for which drugs are considered safe during breastfeeding and which should be avoided. Check with your doctor before taking any medication while breastfeeding.

OTC painkillers themselves come in two categories, based on their active ingredient(s):

  • Acetaminophen, the active ingredient in Tylenol, 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) include aspirin as well as Advil or Motrin (ibuprofen) and Aleve (naproxen). Aspirin should be avoided by nursing mothers because its blood-thinning properties can cause rashes or bleeding abnormalities in breastfed infants. Ibuprofen and naproxen, however, are considered safe for mother and baby.

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.

Codeine is frequently used in combination with acetaminophen as a painkiller or cough suppressant. But some nursing mothers -- especially those of North African, Ethiopian and Saudi Arabian descent -- metabolize codeine more rapidly than others, leading to a potentially lethal drug buildup of morphine (codeine metabolizes into morphine in the body) in their 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 feeding. Regular use of opioids by breastfeeding mothers is not advised.

Nursing mothers should always tell any physician if they are breastfeeding, especially those doctors who prescribe pain medication.  Sometimes a physician will prescribe something without realizing or asking if the mother is nursing.

Sources:

"Breastfeeding: Frequently Asked Questions." cdc.gov. 27 Jul. 2007. Centers for Disease Control. 5 Feb. 2009 <http://www.cdc.gov/breastfeeding/faq/index.htm>.  



"Is It Safe for My Baby?" camh.net. 2009. Centre for Addiction and Mental Health. 9 Feb. 2009 <http://www.camh.net/Publications/CAMH_Publications/is_it_safe_my_baby.html>.  



"Medication Exposures During Pregnancy and Breastfeeding: Frequently Asked Questions." cdc.gov. 29 Oct. 2004. Centers for Disease Control. 3 Feb. 2009 <http://www.cdc.gov/ncbddd/meds/faqs.htm>.



"Narcotic Painkillers." kaiserpermanente.org. 30 Oct. 2007. Kaiser Permanente Hospital Network. 9 Feb. 2009 <http://members.kaiserpermanente.org/kpweb/healthency.do?hwid=zx1135>.



"OTC Medicines and How They Work." familydoctor.org. March 2008. American Academy of Family Physicians. 3 Feb. 2009 <http://familydoctor.org/online/famdocen/home/otc-center/basics/otc.html>.



"OTC Products and Certain Patient Groups." aafp.org. 2009. American Academy of Family Physicians. 3 Feb. 2009 <http://www.aafp.org/online/en/home/publications/otherpubs/afpmonographs/otc/objectives/products.html>.  



"The Transfer of Drugs and Other Chemicals into Human Milk." aappublications.org. Sept. 2001. American Academy of Pediatrics. 6 Feb. 2009 <http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776>.



"Use of Codeine Products in Nursing Mothers." fda.gov. 17 Aug. 2007. US Food and Drug Administration. 10 Feb. 2009 <http://www.fda.gov/CDER/Drug/infopage/codeine/qa.htm>.  


LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Maureen Salamon is a New Jersey-based freelance writer whose work has appeared in a variety of online and print publications.

©2014 About.com. All rights reserved.

We comply with the HONcode standard
for trustworthy health
information: verify here.