From the Guidelines
Both Tylenol (acetaminophen) and Advil (ibuprofen) are generally considered safe to use while breastfeeding a newborn, as they transfer into breast milk in very small amounts that are unlikely to cause problems for most healthy, full-term infants. When considering the use of these medications, it's essential to look at the most recent and highest quality studies. According to the guideline on anaesthesia and sedation in breastfeeding women 2020 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. However, it's crucial to note that while the provided evidence does discuss the safety of various NSAIDs during breastfeeding, the safety of Tylenol (acetaminophen) is not explicitly mentioned in the given studies. Despite this, the general consensus in medical practice, based on the principle of minimizing risk and maximizing benefit, especially concerning morbidity, mortality, and quality of life, supports the use of acetaminophen as safe during breastfeeding, given its widespread use and the low levels at which it is secreted into breast milk. For Advil (ibuprofen), the typical dose is 200-400 mg every 4-6 hours, not exceeding 1,200 mg in 24 hours unless directed by a healthcare provider 1. It's always best to take the lowest effective dose for the shortest time needed. If you have any concerns about your specific situation, such as if your baby was premature or has health issues, check with your pediatrician before taking these medications, and avoid combination products containing other active ingredients, as those may not be as well-studied in breastfeeding. Additionally, while the American Academy of Pediatrics considers ibuprofen safe in breastfeeding women, with trace amounts found in breast milk 1, it's essential to be aware of potential risks, such as the displacement of bilirubin by NSAIDs, which could be contraindicated in neonates with jaundice. Given the information and prioritizing the most recent and highest quality evidence, the use of Tylenol and Advil during breastfeeding is considered safe when used appropriately and under guidance.
From the FDA Drug Label
Nursing Mothers 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. If pregnant or breast-feeding ask a health professional before use.
Safety with Breast-feeding:
- Ibuprofen (Advil): The FDA drug label does not provide enough information to determine the safety of ibuprofen with breast-feeding a newborn, as it states that it is not known whether the drug is excreted in human milk 2.
- Acetaminophen (Tylenol): The FDA drug label advises to ask a health professional before use if breast-feeding, but does not provide direct information on safety with breast-feeding a newborn 3. The FDA drug label does not answer the question.
From the Research
Safety of Tylenol and Advil with Breastfeeding
- Tylenol (acetaminophen) is considered safe for use during breastfeeding, as stated in the study 4, which notes that "breast-feeding during maternal treatment with paracetamol (acetaminophen) should be regarded as being safe."
- Advil (ibuprofen) is also considered safe for short-term use during breastfeeding, according to 4, which recommends "short-acting agents without active metabolites, such as ibuprofen, should possibly be preferred" for long-term treatment.
- Another study 5 confirms that "maternal administration or ingestion of most NSAIDs results in low infant exposure via breastmilk, such that both cyclooxygenase-1 and cyclooxygenase-2 inhibitors are generally considered safe, and preferable to aspirin, when breastfeeding."
- Additionally, 6 states that "acetaminophen and ibuprofen are preferred analgesics during lactation," further supporting their safety for use during breastfeeding.
Precautions and Considerations
- When taking medications, breastfeeding mothers should be instructed to take their medication after breastfeeding, at the lowest effective dose and for the shortest duration, as noted in 7.
- It is also important to consider the potential risks and benefits of continuing breastfeeding while taking medications, as stated in 4, which recommends that "the possible risks to the infant should always, and on an individual basis, be carefully weighed against the benefits of continuing breast-feeding."
- Furthermore, 6 advises prescribers to use current, accurate resources, such as LactMed, to determine the safety of medications during breastfeeding.