Which painkillers are safe to take in pregnancy and when you are breastfeeding?
You're expecting or feeding and you have the headache from hell – is it OK to pop a pill?
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. That doesn’t mean you shouldn’t use them, but that you should weigh up the risks and benefits. 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. However, very low-dose aspirin 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 Reye’s Syndrome, causing damage to the liver and brain - a link has 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.
Can I take paracetamol during pregnancy?
This is another drug that reduces both pain and fever. ‘Unless you’re allergic to it, paracetamol is the recommended painkiller to use during pregnancy,’ says Jane. ‘There are no studies showing risks of any birth defects associated with it.’ But as with any medicine taken during pregnancy, use paracetamol at the lowest effective dose for the shortest possible time. If the recommended dose of paracetamol doesn't control your symptoms or you're in pain, get more advice from your midwife or GP.
Can I take paracetamol while breastfeeding?
Paracetamol does pass into breast milk but the amount your baby would receive is very small and so it’s deemed OK. Take it for the shortest possible time and stick to the recommended dose.
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, unless on the advice of a doctor. This is because taking ibuprofen at this stage is associated with an increased risk of complications, including a heart problem in your baby and a reduced amount of amniotic fluid.
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. However, take it for the shortest possible time and stick to the recommended dose.
Can I take codeine during pregnancy?
Codeine is a stronger painkiller that is normally given for mild to moderate pain. It Isn’t recommended during pregnancy. ‘There’s no known risk of birth defects associated with taking codeine in pregnancy,’ says Jane ‘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.’
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 it’s not generally 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 breast milk 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.