Analgesics (painkillers) are among the most commonly used medications during breastfeeding. Often, after taking them, the nursing mother develops fears and worries about whether they might harm the baby.
Paracetamol is considered the safest analgesic (painkiller) for mild to moderate pain during breastfeeding. Like ibuprofen, it is a non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is more effective than paracetamol for more severe pain.The use of both agents during breastfeeding has been well studied. They are detectable in small amounts in breast milk. However, side effects for the child have not been described.
Diclofenac is considered a second-line agent after paracetamol in the breastfeeding period. It has been well studied. Again, small amounts are detectable in breast milk – side effects in the child have not been observed.
Acetylsalicylic acid (ASA) passes into breast milk. In nursing mothers, occasional use of ASA is acceptable. A maximum dosage of 1.5 g/day is recommended.
Opioid analgesics should be taken only for short periods during breastfeeding because of their respiratory depressant effect (flattening/reduction of breathing). They are prescribed for severe pain.Single doses of codeine for 1-2 days do not require a break from breastfeeding. Single doses of tramadol also appear to be unproblematic.Long-term use of opioid analgesics must be expected to cause respiratory problems and withdrawal symptoms in the child.
Morphine should only be taken under medical supervision. This also affects the baby’s breathing.
Analgesics should always be taken immediately after breastfeeding. If the child already has longer sleep phases, it is best to take the analgesic in the evening.
The following analgesics are not allowed because there is insufficient experience on their use during breastfeeding:
- Coxibe (COX-2 inhibitors): etoricoxib – for osteoarthritis, rheumatoid arthritis, gout.
- Indometacin – for rheumatic diseases.
- Meloxicam – in osteoarthritis, ankylosing spondylitis, chronic polyarthritis.
- Naproxen – anti-inflammatory (anti-inflammatory), antipyretic (antipyretic).
- Piroxicam – analgesic and anti-inflammatory.
Similarly, combination drugs should be avoided.
A breastfeeding woman should in no case abandon a painkiller that is important for you (for example, in the context of a rheumatic disease). Pain management is not always a reason to stop breastfeeding.
