I have a headache but am also breastfeeding. What can I safely take for me and my baby? Well, first, if you have a headache, start by drinking water. I see many new mothers who are breastfeeding who are not getting adequate nutrition and specifically hydration because of focusing on their little one. If you have a new onset headache, before reaching for the medicine cabinet, start by hydrating. Water, coconut water, soups or births, and High water fruits and vegetables like melon , pineapple, oranges or citrus fruits and cucumber, lettuce, and celery. If that doesn’t do the trick , there are safe medications to take. Dr Thomas Hale wrote the textbook on medication and breastmilk and categorizes them into 5 categories:
- L1 safest
- L2 safer
- L3 probably safe
- L4 possibly hazardous
- And L5 hazardous.
If you have pain, such as a headache, body aches, pain post delivery or a fever, there are safe medications.
Ibuprofen, Advil, and Motrin are all nonsterioial anti-inflammatory analgesics (NSAIDs), and considered L1 or preferred medications. Panadol, acetaminophen or Tylenol are pain relievers that are considered L1 and safe while breastfeeding. Aspirin, ASA, is considered an L2 medication. While L2 medications are typically considered safe while breastfeeding, Aspirin use can lead to a condition in babies and children called Reye Syndrome which has been associated with brain and liver damage. Aleve (also known as Naproxen) is considered an L3 and while the AAP-approved it for nursing mothers, Dr Hale states it should be used with caution due to its long half-life and its potential effect on baby’s cardiovascular system, kidneys and GI tract. Use of Aleve should be short-term, infrequent or occasional use which would still be considered compatible with breastfeeding.
Ibuprofen or acetaminophen are better choices over aspirin and naproxen for pain relief in lactating women and you would want to discuss the risks and benefits of aspirin If your physician has prescribed this for you based on your unique medical history.
Codeine is an L3 medication and not generally recommended while breastfeeding. If it is essential, and only where there is no alternative, it should be at the lowest effective dose for the shorted possible duration and you should stop taking it and seek medical attention if you notice side effects in your baby such as breathing problems, lethargy, poor feeding, drowsiness or slow heart beat.
If you have another medication that you take for fever or pain, you can ask the IBCLC lactation consultant you’re working with to check out it’s safety in the Hale’s Medications and Mother’s Milk textbook, on you can search the LactMed database on the internet. You can also call Infant Risk which is a help center for questions about breastfeeding, infants and medications. If you are in the USA, The phone number for the call center is 1(806) 352-2519 and is open from 8 AM to 5PM Central Standard Time to answer your questions.