Safety of Ibuprofen During Breastfeeding
Ibuprofen is safe to use while breastfeeding and is considered compatible with lactation. 1
Evidence and Rationale
Ibuprofen has been extensively studied in the context of breastfeeding and is considered one of the preferred analgesic options for nursing mothers for several reasons:
According to the Association of Anaesthetists guideline (2020), ibuprofen "has been used extensively for postpartum pain and during lactation, and is considered safe to use during breastfeeding." 1
Ibuprofen is specifically listed among the analgesics that are "compatible with breastfeeding" in the guideline's comprehensive review of medications used during lactation. 1
It is part of the recommended multimodal analgesia approach for breastfeeding women, as "paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs; including cyclo-oxygenase-2 inhibitors) are compatible with breastfeeding." 1
Pharmacological Considerations
The safety profile of ibuprofen during breastfeeding is supported by its pharmacological properties:
- Only small amounts of ibuprofen are transferred into breast milk
- The relative infant dose is very low
- It has been extensively used in postpartum pain management without reported adverse effects in breastfed infants
Clinical Recommendations
When using ibuprofen while breastfeeding:
- Use the lowest effective dose for the shortest duration needed
- Standard dosing regimens are considered safe
- No need to interrupt breastfeeding or "pump and dump" after taking ibuprofen
- No special timing of doses relative to feeding is required
Important Considerations
- Acetaminophen (paracetamol) and ibuprofen are both considered preferred analgesics during lactation 2
- For long-term treatment, ibuprofen may be preferable to other NSAIDs due to its short-acting nature and lack of active metabolites 3
Cautions
While ibuprofen is safe during breastfeeding, it's important to note that NSAIDs including ibuprofen should be avoided:
- At about 30 weeks gestation and later in pregnancy due to risk of premature closure of the fetal ductus arteriosus 4
- In women who are pregnant (not relevant to the breastfeeding question, but important to distinguish)
Summary
Ibuprofen is a safe and appropriate analgesic choice for breastfeeding mothers. The evidence consistently shows that it poses minimal risk to the breastfed infant, and it is specifically recommended as a compatible medication during lactation by authoritative guidelines.