Taking Pain Medications While Breastfeeding

Breastfeeding is the optimal source of nutrition for infants and whenever possible, infants should be breastfeed. Even so, many nursing mothers worry about whether or not they should continue to breastfeed if they are taking prescription medications. These moms may become especially worried if they are on prescription pain relievers such as morphine, oxycodone or vicodin. I am often surprised by the amount of people I meet who believe that its dangerous to breastfeed on these medications.

Treating pain while breastfeeding
Pain can come in all shapes, sizes and forms whether you’re pregnant, lactating, man, woman or child. Mild pain can usually be treated with over-the-counter medications, such as acetaminophen or ibuprofen. More severe pain may not respond to these medications and may require stronger, prescription medications. These medications are often considered narcotic and can have very serious side affects. Because of the seriousness of these medications, many mothers are afraid that they may inadvertently drug or harm their child if they breastfeed while on pain medications.

Because of this fear, many women feel that using formula is a safer alternative to feeding their child breast milk that could contain pain medications. In many cases, however, this belief isn’t always accurate and giving the child formula has the potential to permanently damage the mother and child’s breastfeeding relationship. Many women (and men) believe that “just one bottle,” won’t hurt, but even one bottle can have serious consequences, especially if the mother felt strongly about breastfeeding.

Every medication is different when it comes to breastfeeding
Medications don’t just pass through the breast milk in the same levels and amounts as the mother receives them. There is not magic number or percentage for how much the medication passes through into the breast milk. The rate of transfer depends on several different aspects of the medication and the patient, such as the molecular weight, the half life, the dose, the relative infant dose and the theoretic infant dose. These terms can be confusing and difficult to understand. Most patients aren’t even aware of the significance of these aspects of medicating, and some doctors are even unaware.

A great resource for investigating the safety of medications while breastfeeding is the book “Medications and Mother’s Milk” by Dr. Hale. Dr. Hale’s book has the information for hundreds of medications listed, as well as the safety concern of use during lactation. The book clearly outlines any pediatric concerns that may be present in a nursing child who’s mother is on a medication. Although the book should never replace the guidance of your physician and pediatrician, it can be a great resource. Many mothers find it helpful to bring the book with them to doctor appointments.

Making the choice to use pain medications while breastfeeding
It can be hard to decide whether or not to use pain medications while breastfeeding. No mother wants to harm her baby through breastfeeding, but sometimes the mother’s own pain can be too much to bear. In 2009, I had a cesarean section, my wisdom teeth removed, a back injury and an emergency appendectomy all within the course of six months. As you can imagine, these events caused a great deal of physical pain, and like many breastfeeding mothers, I was faced a difficult choice; Do I continue nursing my son while I’m on pain medications?

Ultimately, I decided to continue nursing despite the medications. After researching the medications and speaking in-depth with my physician about my concerns, I decided that the benefits of continuing to breastfeed (even on pain medications) greatly outweighed the risks of switching to formula. Of course, these decisions were evaluated each an every time a new medication was proposed by my caregiver, and in some cases, we worked together to find a more breastfeeding-friendly alternative.

Over the course of those seven months, I underwent spinal anesthesia and general anesthesia. I was treated using intravenous morphine and demerol. I was given nitrous oxide. I was prescribed oxycondone, tramadol, valium, demerol and dilaudid. These medications (and others) may have the potential to cause problems but can be used safely while breastfeeding if both mother and child are closely supervised and monitored during treatment.

Taking pain medications safely while breastfeeding
If you choose to use pain medications while breastfeeding, it is very important that you are well educated about the medication and how it may affect you or your child. Before beginning treatment, ask your doctor if there are any warning signs or symptoms to look for in your infant, and be sure to look for any unusual or abnormal behavior in your infant.

Never take pain medications that were not prescribed to you, especially while breastfeeding. You should also avoid sleeping with your child while under the influence of pain medications as this could pose a risk to your child as well as increase their risk of dying from SIDS.

Additionally, it is important to remember that pain medications can affect your cognitive abilities. You may feel drugged, dizzy, disorientated and may have difficulty focusing or concentrating. If you find yourself needing to use pain medication, try to have someone responsible with you to help you care for your baby. It can be easy to fall asleep on pain medications and not hear the baby cry.

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