by Anne Eglash MD, IBCLC, FABM
What are the safest pain medications to take during breastfeeding? Lately, the media has been raising awareness of the opiate crisis in our country, with thousands of people dying from overdosing on heroin, prescription narcotics, and other illicit substances. The authors of a recent update on pain management for women published in the American Journal of OB/Gyn point out that opiate prescribing has skyrocketed in the USA since 2001, when hospitals were expected to measure pain as a ‘vital sign’. This has led to more aggressive treatment of pain using narcotics.
Breastfeeding women are often given narcotics for their postpartum pain, and for other medical/post-operative pain during the course of lactation. The purpose of this recent update is to highlight non-narcotic options and the safest narcotic options to treat pain during lactation.
According to these authors, what do you believe are true statements regarding the use of pain medication during lactation? Chose 1 or more:
- The only safe anti-inflammatory (NSAID) medication during lactation is ibuprofen.
- Anti-inflammatory medications should be avoided if the infant has a heart condition that depends on a patent ductus arteriosus.
- Low doses of morphine have the lowest transmission into breastmilk, as compared to other opiates.
- Oxycodone is preferred over hydrocodone because hydrocodone causes too much infant sedation.
- Codeine should be avoided in breastfeeding women because some mothers and infants are ultrafast metabolizers, at risk for respiratory depression from this.
- The USA consumes the highest amounts of opiates, accounting for 99.7% of hydrocodone use globally.
Sally Hammerman
Excellent information for those of us who work/consult with breastfeeding women. Although we may not have the ability to prescribe, we do have the ability to observe and comment.
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