Meloxicam (Mobic) During Breastfeeding
Meloxicam should be avoided during breastfeeding, and safer NSAID alternatives like ibuprofen or diclofenac should be used instead.
Why Meloxicam Is Not Recommended
While the provided evidence does not specifically address meloxicam, the absence of safety data combined with the availability of well-studied alternatives makes it a poor choice for breastfeeding mothers. The European League Against Rheumatism (EULAR) guidelines explicitly state that ibuprofen has the most reassuring data among all NSAIDs during lactation, followed by diclofenac 1.
Preferred Safe Alternatives
Use ibuprofen as the first-line NSAID for breastfeeding mothers:
- Ibuprofen is explicitly listed as compatible with breastfeeding by the Association of Anaesthetists, with no requirement to interrupt nursing or express and discard breast milk 1
- The American Academy of Pediatrics recommends ibuprofen as a preferred non-opioid analgesic for breastfeeding mothers with a favorable safety profile 1
- Ibuprofen has been used extensively for postpartum pain and during lactation, with low levels of excretion in human milk 1
- Breastfeeding can occur immediately after taking ibuprofen without any waiting period 1
Diclofenac is the second-best alternative:
- EULAR guidelines rank diclofenac as the second safest NSAID option after ibuprofen during lactation 1
- The Association of Anaesthetists lists diclofenac as compatible with breastfeeding 1
Ketorolac is also safe for short-term use:
- The Association of Anaesthetists lists ketorolac as a safe analgesic option for breastfeeding women 2
- Minimal transfer into breast milk makes ketorolac substantially safer than opioid alternatives 2
- Use at the lowest effective dose for the shortest period of time 2
Dosing Principles for All NSAIDs
- Use the lowest effective dose for the shortest duration needed 1
- Multimodal analgesia combining NSAIDs with paracetamol (acetaminophen) is encouraged to minimize the need for stronger medications 1
- Paracetamol is also completely safe during breastfeeding, with infant exposure significantly less than pediatric therapeutic doses 1
Special Considerations for Young Infants
- Exercise extra caution if the infant is less than 6 weeks of age (corrected for gestation) due to immature hepatic and renal function 2, 1
- Preterm infants have the highest sensitivity to medications, followed by neonates, then young infants 1
- In infants with jaundice, NSAIDs should be used with caution as they can displace bilirubin 1
Common Pitfalls to Avoid
- Do not unnecessarily express and discard breast milk after taking ibuprofen, diclofenac, or ketorolac—this is completely unnecessary 1
- Avoid COX-2 inhibitors (like celecoxib) during lactation, as EULAR guidelines note that data for these agents are limited 1
- Do not choose meloxicam when well-studied alternatives with extensive safety data are available 1