Low-Dose Aspirin for Six Weeks Postpartum While Breastfeeding
Your provider's prescription of baby aspirin (81 mg) for the first six weeks postpartum should be discontinued at delivery, not continued into the postpartum period, unless you have a separate cardiovascular indication unrelated to pregnancy.
Why Aspirin Should Stop at Delivery
The evidence-based indication for low-dose aspirin in pregnancy is preeclampsia prevention during gestation, and all major guidelines specify continuation "until delivery"—not into the postpartum period 1, 2, 3.
- The American College of Obstetricians and Gynecologists explicitly recommends that low-dose aspirin initiated for preeclampsia prevention should be continued daily until delivery 1.
- Multiple international guidelines from the USA, Canada, Ireland, New Zealand, and the UK specify continuation until delivery rather than stopping at a predetermined gestational age or extending into postpartum 1.
- The rationale for continuing through delivery is that preeclampsia risk persists throughout pregnancy and even into the early postpartum period, with eclamptic seizures potentially developing for the first time after delivery 1.
Safety During Breastfeeding
If there is a separate medical reason to continue aspirin postpartum (such as cardiovascular disease or antiphospholipid syndrome), low-dose aspirin is generally considered compatible with breastfeeding, though this should be discussed with your provider 4.
- The FDA label states to "ask a health professional before use" if breastfeeding, acknowledging that aspirin can be used but requires medical guidance 4.
- The FDA warning about aspirin in the "last 3 months of pregnancy" refers to high-dose aspirin (>100 mg), not the prophylactic low doses (75-81 mg) used for preeclampsia prevention 1, 4.
Common Pitfall to Avoid
Do not confuse pregnancy-related aspirin prophylaxis with postpartum continuation. The mechanism of aspirin for preeclampsia prevention—improving placentation and uteroplacental blood flow—is only relevant while the placenta is present 1. Once you deliver, this indication no longer exists.
- Aspirin's anti-inflammatory, anti-angiogenic, and antiplatelet effects specifically target placental ischemia and abnormal placentation, which are central to preeclampsia pathophysiology 1.
- The timing of aspirin for preeclampsia prevention is restricted to the gestational period and differs from its use for long-term cardiovascular disease prevention 1.
What You Should Do
Contact your provider to clarify the indication for postpartum aspirin. If the prescription was intended solely for preeclampsia prevention during pregnancy, it should have been stopped at delivery 1, 2, 3. If there is another medical reason (such as history of blood clots, antiphospholipid syndrome, or cardiovascular disease), that is a different indication requiring separate discussion.