From the Guidelines
Ibuprofen is generally considered safe to use during breastfeeding, as only small amounts of the medication pass into breast milk, making it unlikely to cause adverse effects in most nursing infants. The standard adult dosage of ibuprofen (200-400 mg every 4-6 hours, not exceeding 1200 mg in 24 hours without medical advice) can be taken by breastfeeding mothers for short-term pain relief or fever reduction. According to the most recent guideline from the Association of Anaesthetists 1, ibuprofen has been used extensively for postpartum pain and during lactation, and is considered safe to use during breastfeeding.
Key Points to Consider
- Ibuprofen is preferred over some other pain relievers during lactation because of its minimal transfer into breast milk and short half-life in the body.
- For nursing mothers requiring pain management, ibuprofen is often recommended as a first-line option, especially when compared to other NSAIDs.
- However, as with any medication during breastfeeding, it's best to use the lowest effective dose for the shortest duration needed to treat symptoms.
- If long-term use is necessary or if the infant is premature or has known medical conditions, consulting with a healthcare provider is advisable to ensure the medication remains appropriate for your specific situation.
Additional Considerations
- The American Academy of Pediatrics also considers ibuprofen safe in breastfeeding women, with trace amounts found in breast milk 1.
- Other studies have shown that many RMD medications, including NSAIDs, may be initiated or continued during lactation, with ibuprofen being a recommended option 1.
- It's essential to note that individual needs for analgesia will vary, and multimodal analgesia with non-opioid drugs, such as paracetamol and NSAIDs, should be encouraged 1.
From the FDA Drug Label
It is not known whether this drug is excreted in human milk Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from ibuprofen tablets, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Ibuprofen use during breastfeeding is not recommended due to the potential for serious adverse reactions in nursing infants and the uncertainty of whether the drug is excreted in human milk. A decision should be made to either discontinue nursing or discontinue the drug, considering the importance of the drug to the mother 2.
From the Research
Ibuprofen and Breastfeeding
- Ibuprofen is considered compatible with breastfeeding by the American Academy of Pediatrics (AAP) 3
- The amount of ibuprofen that enters breast milk is relatively low, and the risk to the infant is considered to be minimal 4, 5
- Studies have shown that the transfer of ibuprofen into breast milk decreases with the protein concentration and the duration of lactation 6
- The relative infant dose of ibuprofen is less than 0.38% of the weight-adjusted maternal daily dose, which is equivalent to 0.2% of the infant dose 6
Safety Considerations
- Breastfeeding mothers should take ibuprofen at the lowest effective dose and for the shortest duration necessary 3, 4
- Mothers should be instructed to take their medication after breastfeeding, to minimize the amount of ibuprofen that enters the breast milk 3
- Infants should be monitored for any adverse effects, such as sedation or irritability, although the risk is considered to be low 3, 4
Comparison to Other Analgesics
- Ibuprofen is preferred over aspirin due to its lower risk of adverse effects in breastfed infants 4, 5
- Acetaminophen is also considered safe for use during breastfeeding, and may be preferred over ibuprofen in some cases 4, 7
- Other analgesics, such as codeine and morphine, may be used during breastfeeding, but require closer monitoring of the infant due to the risk of adverse effects 4, 7