Ibuprofen Use During Breastfeeding
Ibuprofen is considered safe to use during breastfeeding and can be used without interruption of breastfeeding. 1
Safety Profile
Ibuprofen has been extensively studied in the context of breastfeeding and demonstrates an excellent safety profile for nursing mothers:
The 2020 guidelines from the Association of Anaesthetists explicitly state that ibuprofen "has been used extensively for postpartum pain and during lactation, and is considered safe to use during breastfeeding." 1
The transfer of ibuprofen into breast milk is minimal. Research shows that the relative infant dose is less than 0.38% of the weight-adjusted maternal daily dose, which is far below the level of concern (generally 10%). 2
The theoretical infant dose has been calculated at only 68 mcg·kg⁻¹·d⁻¹, which equals approximately 0.2% of a therapeutic infant dose. 2
Pharmacokinetic Considerations
Several factors make ibuprofen particularly suitable for breastfeeding mothers:
Ibuprofen transfer into breast milk decreases with:
- Increasing protein concentration in milk
- Duration of lactation 2
The amount of ibuprofen that would be ingested by an infant via breast milk is significantly lower than pediatric therapeutic doses. 1
Dosing Recommendations
When using ibuprofen while breastfeeding:
- Use the lowest effective dose for the shortest duration needed
- Standard adult dosing applies (typically 400-600mg every 6-8 hours, not exceeding 3200mg daily)
- No need to time breastfeeding around medication administration
- No need to "pump and dump" breast milk after taking ibuprofen 1
Advantages Over Other Analgesics
Ibuprofen has several advantages over other pain medications during lactation:
- Unlike codeine, which has caused fatal intoxication in a breastfed neonate, ibuprofen has an advantageous benefit-risk profile 2
- Unlike aspirin, which should not be used in analgesic doses during breastfeeding, ibuprofen poses no significant risk 1
- Unlike some opioids that require monitoring of the infant for sedation, ibuprofen does not cause central nervous system effects in breastfed infants 1
Important Considerations
While ibuprofen is safe during breastfeeding, be aware of these considerations:
- Avoid NSAIDs including ibuprofen during pregnancy at about 30 weeks gestation and later, as they can cause premature closure of the fetal ductus arteriosus 3
- If you're both pregnant and breastfeeding (tandem nursing an older child), consult your healthcare provider about ibuprofen use
- Ensure adequate hydration while taking ibuprofen
Conclusion
Based on extensive clinical experience and research evidence, ibuprofen is a safe and effective analgesic and anti-inflammatory medication for breastfeeding mothers. The minimal transfer into breast milk and lack of reported adverse effects in nursing infants make it one of the preferred pain relief options during lactation.