Postpartum: Can you nurse with postpartum painkillers?

After my first birth, a cesarean, I did not breastfeed. I was given pain killers by IV and was told they could harm the baby. I am pregnant with my second child and I wonder if it would be safe to breastfeed even if I am given pain killers again.

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Kathy Kuhn

Kathy Kuhn is a registered nurse who has been working with breastfeeding families since 1981. She has been an International Board Certified... Read more

There are many pain medications that are considered compatible with breastfeeding. Most breastfeeding mothers who have cesareans are breastfeeding right after their surgery and continue to breastfeed even during the use of pain relief medications in their recovery period.

It is now known that most medications do not pass into breastmilk in large enough quantities to be clinically significant for the infant. Most commonly the amount passed is less than one percent of the mother's dose. (Hale 99) Still, you should always ask your physician about specific medications before using them during breastfeeding since there are some exceptions. Ask your doctor to reference some appropriate resources to determine what medication might be best for you and compatible with breastfeeding.

Two widely used and excellent resources are "Medications and Mothers' Milk 2000" by Dr. Thomas Hale and "The American Academy of Pediatric's Committee on Drugs, Transfer of Drugs and Other Chemicals into Human Milk." Some physicians only check the pharmaceutical company information, which almost always discourages breastfeeding with the use of their medications. This is due to concern about possible lawsuits should a problem occur, and not usually based on the latest studies about that drug's affect on the nursing newborn. (Hale 99)

Talk to your doctor before your surgery and stress to her how strongly you feel about breastfeeding. Ask that she try to give only medications that are compatible with breastfeeding.

References

American Academy of Pediatrics, Committee on Drugs, The transfer of drugs and other chemicals into human breast milk. Pediatrics 1989 84: 924-936.

Hale, T., Medications and Mother's Milk, Pharmasoft Medical Publishing, 1999 pp 5-9.

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