Safe painkillers for breastfeeding

Can I take a painkiller?

Now you’re nursing your baby, you may worry about taking medication that could harm him if it passes into your breast milk. The FDA recently warned that some moms may be genetically predisposed to rapidly metabolize certain drugs – so how can you be sure your baby is safe?

 

Is your baby at risk?

A recent case where a breastfed baby died from a morphine overdose after his mom was advised to take painkillers containing codeine underlines the need for new moms and their doctors to be vigilant about what medications they take while breastfeeding. Codeine is an ingredient in many painkillers and cold/cough remedies, and many are available over-the-counter. You may be advised to take one to help you cope with post-birth aches and pains – for example, pain caused by an episiotomy or cesarean. Some migraine medications also contain codeine. If it’s metabolized rapidly, the quantities that pass into your baby via breast milk will be higher and could be too much for him to cope with.

Be vigilant

As a rule, it’s generally considered safe to take acetaminophen and ibuprofen while breastfeeding, but as a precaution consult your pharmacist before taking any OTC medication. Check with your doctor that anything she prescribes is safe too and that she gives you the lowest possible dose for the shortest possible time (it may be worth double checking with your baby’s pediatrician). Bear in mind too that your genetic heritage may have a bearing on how your body metabolizes some drugs – in the case of codeine, you’re more likely to be a rapid metabolizer if you’re of North African, Ethiopian and Saudi Arabian descent – between 16 and 28% of these groups have the tendency (it falls to 1-10% among Caucasians, 1% of Hispanics and 1-3% of Asians).

If your doctor wants to prescribe any medication that is contra-indicated for breastfeeding ask if there is any possible alternative before accepting it. Although your doctor may suggest temporarily weaning your baby onto formula while you take the medicine, it may be extremely difficult to get your baby back on the breast. If you need to take painkillers but are already giving your breastfed baby infant acetaminophen or ibuprofen for a cold, check with your pediatrician.

Recognize the signs…

• You may find you feel excessively sleepy a short time after taking your medication.
• Your baby may seem overly drowsy, have difficulty feeding, exhibit breathing difficulties and feel limp. If you are at all concerned, take him to the ER, bringing any medication you have been taking with you.

 

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