Painkillers during pregnancy
The question about painkillers in pregnancy cannot always be answered absolutely. A distinction must always be made between one-time intake and permanent intake. The rule is: “As much as necessary, as little as possible”.
A doctor should always be consulted and consulted before taking a pill. Acetylsalicylic acid (Aspirin®) and other non-steroidal painkillers should not be used in the last trimester of pregnancy due to their contraction-inhibiting properties. They also have the additional property of closing the fetal connection between the large fetal blood vessels of the lungs and the body’s circulation and are held responsible for various heart defects and kidney damage.
Only the active ingredient ibuprofen from this group can be used up to the 28th week of pregnancy according to the current state of knowledge. Paracetamol is generally recommended as the treatment of choice for pain throughout pregnancy. However, this should also only be used after consultation with a doctor and the maximum daily dose should be observed urgently.
Opiates are not absolutely prohibited during pregnancy and lactation. According to many literature references, individual doses in urgent cases have no harmful effect on the unborn child. Only permanent use should be avoided and ibuprofen and paracetamol should be avoided until the 30th week of pregnancy.
The reason is the transition of opiates into the child’s circulation through the placenta. Opiates then have the same effects in the child’s circulation as they do in the mother’s, and in the worst case this can lead to “addiction”. If taken permanently after birth, the child may experience a sudden withdrawal with all the effects of opiate withdrawal and, as in adults, overdose may lead to respiratory arrest.
Painkillers in the nursing period
Also for the breastfeeding period there are some things to consider with regard to the intake of medication, since a large part of the medication is passed on to the child via the breast milk and develops its effect there. It is best to take fast-acting medications after breastfeeding so that the majority of the active ingredient is no longer in the mother’s blood until the next breastfeeding and therefore does not pass into breast milk. As in pregnancy so also in the lactation period applies: “As much as necessary, as little as possible”.
Among the non-opiates, as in pregnancy, paracetamol is considered the remedy of choice against pain. Alternatively, ibuprofen can be used, which is also the drug of choice for babies and thus does not cause any damage to the child when transmitted through breast milk. The following also applies to opiates during the breastfeeding period: Experience shows that isolated doses do not pose a problem, and long-term use should be avoided, even if only small amounts of the opiates pass into breast milk.
