Types of painkillers: Can they be taken by children or during pregnancy?

Types of painkillers: Can they be taken by children or during pregnancy

You're expecting and you have the headache from hell - should you pop a pill? And what about dosing up little ones with they're unwell? From taking paracetmol in pregnancy to knowing whether it's safe to give your child ibuprofen, we explain your pain relief options.


Image: iStock

The problem with taking any drugs when you’re pregnant is that we lack the absolute science as to how they might affect your baby. While drugs are thoroughly tested before they come on to the market, most trials exclude pregnant women. The reason is sensible: many drugs pass from mum to the foetus and drug companies don’t want to take the risk that something bad might happen during a trial. The downside of this is that we can’t find out for sure whether a drug is safe for a mum-to-be.

Scientists are now investigating the potential effects of painkillers taken in pregnancy or while breastfeeding on conditions that develop later in childhood, including asthma, hyperactivity and learning problems – and this is throwing up potential links. These links are very small, and the research is not conclusive but it does mean that right now, experts can’t say any painkiller is completely safe to use when you’re pregnant or breastfeeding.

That doesn’t mean you shouldn’t use them, but that you should weigh up the risks and benefits. The same analysis applies to painkillers for children. If and when you do choose to use painkillers, there are definite rules on what to opt for. Here’s what you need to know.

Can I take aspirin during pregnancy?

Aspirin is one of a class of drugs known as non-steroidal anti-inflammatories (NSAID). It is used to treat pain and fever and, in low doses, is given to thin the blood. ‘As a painkiller we don’t recommend using aspirin in pregnancy as there’s a small risk the drug can damage the stomach lining and cause gastric bleeding,‘ says Jane Bass, spokesperson for the Royal Pharmaceutical Society.

Aspirin taken later in pregnancy can also be linked to a problem called premature closure of the ductus arteriosus. However, very low-dose aspirin – 75mg a day compared to the total of 4g you might take over the course of a day for pain – can be used in pregnancy to reduce the risk of pre-eclampsia and is not deemed to pose a risk. Only take aspirin with a doctor’s advice.

Can I take aspirin while breastfeeding?

‘While we don’t know that there’s a definite risk when breastfeeding, it’s theoretically possible and so we don’t recommend taking it,’ says Jane. One of the problems associated with aspirin is a condition that affects children called Reyes Syndrome, causing damage to the liver and brain. This can develop after a viral infection such as flu or chickenpox, and a link has also been made with children using aspirin while they were ill.

If you’re taking low-dose aspirin for medical reasons, you can still breastfeed, but ask your doctor’s advice on how long to leave between taking aspirin and feeding. You may also be advised to switch to formula if your child has a fever.

Is it safe to give my child aspirin?

Because of the risk of Reyes Syndrome, aspirin is not recommended to any child under 16 without a doctor’s advice.

Can I take paracetamol during pregnancy?

This is another drug that reduces both pain and fever, and is the main ingredient in Calpol. ‘Unless you’re allergic to it, paracetamol is the recommended painkiller to be used during pregnancy,’ says Jane. ‘There are no studies showing risks of any birth defects associated with it.’

One recent study made headlines by linking the use of paracetamol in pregnancy with a slightly higher risk of asthma – it found children were 13 per cent more likely to have asthma by the age of three if their mother had taken paracetamol when pregnant. That’s a small rise though, and the link is by no means proven; the researchers say advice shouldn’t change in light of this.

Can I take paracetamol while breastfeeding?

Paracetamol does pass intoParacetamol does pass intobreast milk but the amount yourbaby would receive is very smalland so it’s deemed Ok.

Is it safe to give my child paracetamol?

‘It is thought to be generally safe for children,’ says Roger. While the recent trial did note a higher risk of asthma in children who had taken paracetamol, it’s not yet proven.

Can I take ibuprofen during pregnancy?

Another member of the NSAID family of drugs, ibuprofen helps reduce pain and fever. Ibuprofen isn’t generally recommended during pregnancy and it must never be used after the 30th week. It’s linked to a problem known as premature closure of the ductus arteriosus.

‘This is the name of a blood vessel in the baby that supplies them with nutrients and oxygen from you. It closes when the baby is born, but must stay open when they are in the womb – however, ibuprofen can cause it to close early,’ explains Jane. NSAIDs taken in late pregnancy have also been linked to reduced levels of amniotic fluid, which can cause complications.

Can I take ibuprofen while breastfeeding?

The known risks to the foetus from ibuprofen disappear once they are born ‘and there’s no risk to using ibuprofen when you’re breastfeeding,’ says Jane.

Is it safe to give my child ibuprofen?

‘Generally, ibuprofen is safe to use on children – the exception to this is those with asthma,’ says Roger. ‘Five to ten per cent of people with asthma find it can aggravate their symptoms and so it’s generally recommended that they don’t use it.’ It’s also not a good idea to give ibuprofen to children who have chickenpox as it can cause a reaction that makes the spots go deeper into the skin, which may then lead to infection.

Can I take codeine during pregnancy? 

Codeine is a stronger painkiller that is normally given for mild to moderate pain. It’s also found in some cough mixtures as it can help suppress coughing. ‘There’s no known risk of birth defects associated with taking codeine in pregnancy, but it is converted to morphine in the body and therefore if it’s taken regularly in the days before giving birth, some babies can potentially suffer withdrawal once they are born,’ says Jane.

If your doctor knows you’ve been taking codeine in the days or weeks before birth, they might want to monitor your baby a bit more carefully afterwards. If you have a long-term pain condition that’s regulated with codeine, ask your doctor’s advice about continuing it when pregnant; if you’ve been taking it for a long time, you might also need advice on what to do if you decide to manage without it.

Can I take codeine while breastfeeding?

Codeine can be given by hospitals as a painkiller after birth, but generally it’s not recommended that you take it when breastfeeding. A very small proportion of the population convert too much from a normal dose to morphine. If you’re one of them, more morphine than normal will enter your breastmilk which can affect your baby – at worst, this can cause problems with breathing. If you need codeine to control a long-term condition but still want to breastfeed, ask your doctor’s advice.

Is it safe to give my child codeine?

‘In the past, codeine used to be commonly used after operations such as tonsillectomy but it’s now contraindicated in children under 12, and also isn’t used in anyone under 18 with a breathing problem called obstructive sleep apnoea,’ says Roger. The reasons for this include the risk of rapid metabolism – in some children the liver may be prompted to convert too much of the codeine dose to morphine – and its potential effect on breathing. In these cases, children can experience severely slowed breathing rates as a consequence.


Did you take medication or avoid using pain relief during pregnancy? Tweet us @GurgleUK or like our Facebook page 



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