I’ve also heard doctors recommend delaying breastfeeding for at least 2-3 days after surgery because pain medication can enter breast milk and is dangerous for baby.
So which is it?
And if C-Section pain medication does affect your breast milk how does it affect your baby?
The effects of C-Section pain medication on your baby depends on the medication.
For example, the use of oral medications such as Oxycodone* when breastfeeding not only cause infant drowsiness, it can cause central nervous system depression; even death according a drugs.com article on the use of Oxycodone while breastfeeding.
Now that’s scary to me.
Many C-Section pain medications used cause nothing more than some drowsiness in baby, however some medications offer more dangerous side effects for your baby.
Here’s a run down of the possible pain drugs administered when having a C-Section and what to look out for.
C-Section Pain Medication & How They Affect Your Baby When Breastfeeding
Morphine. Epidural morphine given to mothers post C-Section results in small amounts of morphine in their colostrum and milk. In fact Intravenous or oral doses of maternal morphine during the immediate postpartum period results in higher milk levels than with epidural morphine according to a drugs.com piece written titled “Morphine use while Breastfeeding“.
For these reasons Morphine is one of the most commonly used drugs for C-Section pain.
Lidocaine, Tetracaine, and Bupivacaine. These drugs are used when administering a spinal and epidural. These leave minimal levels in the breast milk; however they do diminish the baby’s ability to suckle.
Here’s a good article from the LeLeche league on the topic of epidurals and breastfeeding that offers some good information on the connection of breastfeeding and the epidural.
Hydrocodone. There’s no real clear evidence on the amount of hydrocodone that makes it into mother’s milk. According to an abstract in the US National Library of medicine on Hydrocodone excretion into breast milk, moderate dosages of hydrocodone appear acceptable during breastfeeding, but more studies and data are needed to determine the maximum safe dosage for nursing moms.
Newborns and preterm infants may be more susceptible than older infants to adverse effects of hydrocodone and its metabolites in breast milk.
Demerol stays longer in your system and can cause significant sedation for baby. It should not be used during delivery or postpartum in breastfeeding women.
Darvocet (Propoxyphene). Drugs containing Propoxyphene** such as Darvocet should be avoided when breastfeeding. Like Oxycodone, Propoxyphene can cause infant drowsiness, central nervous system depression and even death.
Fentanyl levels are low in the breast milk and it has a shorter life in your bloodstream posing little risk.
Vicodin has been used a lot in breastfeeding mothers and has shown no problems in the infant, however you may want to breastfeed away from the time you take the drug just to be safe.
Codeine is a good drug to avoid if possible. Some women don’t metabolize the drug well causing excessive levels to build up in their system which can cause over-sedation in the baby and that can interfere with baby’s breathing.
Tylenol (Acetaminophen). Tylenol doesn’t enter your milk supply very well so it’s typically a safe medication for pain when breastfeeding when taken in low to moderate doses. However avoid long periods of Tylenol use, limit your daily dosage and use only as directed.
Nonsteroidal analgesics. Pain medications such as Naprosyn, Motrin, ibuprofen and Aleve are generally safe because transfer into the milk is low. Ibuprofen is the best of this group because it can be safely used in infants.
Aspirin. Aspirin levels in breast milk are low. However, the down side to taking aspirin while breastfeeding is the connection to Reyes syndrome. It’s possible that a breastfeeding infant with a virus could contract this syndrome. It may be safer to use another, safer medication while breastfeeding.
Tip: A common drug that’s not a pain medication but can reduce your milk supply is the traditional or “combined” birth control pill. If “the pill” contains estrogen, it is highly likely that it will decrease the amount of milk produced.
Here’s a good rule of thumb when it comes to taking pain medication while breastfeeding.
How much of an effect any of these medications has on your baby specifically is difficult to actually know for sure.
Pain medication and it effects can vary based on dosage, the length of labor, and the characteristics of each individual baby. That’s why it’s so important to discuss at length with your doctor your breastfeeding concerns and your history with medication so that you can determine together the right course of pain relief.
Alternative to Taking More Pain Medication
When we are in pain our first thought is to take medication. For most pain that’s the best alternative but one thing that can help significantly with C-Section pain or any abdominal pain is wearing an abdominal binder.
The reason we have pain is that our internal organs and muscles hurt from the surgery.
We also have a deep incision that is at the root of our pain. The incision is both external and internal so undoubtedly it hurts!
Pain medication is the best way to treat that type of severe pain, however if you’re trying to cut back on the heavier medication but still need some pain relief to get you through the day, you may find that an abdominal binder, specifically binders made for C-Section moms help you not only with pain but with fatigue, and improved energy levels.
With pain being one of the biggest concerns for moms having a C-Section, you owe it to yourself to consider wearing an abdominal binder and minimizing as much of your discomfort as possible without having to take more drugs.
If you want to breastfeed begin as soon as you can after your surgery.
If you’re concerned about how the drugs will affect your baby then voice your concerns with you doctor to determine which drugs s(he) is comfortable with based on your pain levels and what works for you.
With the exception of a few medications mentioned above, the most common medications for C-Section moms will not harm the baby. Of course I would encourage you to take the smallest amount of pain medication needed in order to stay as comfortable as possible in those post-operative hours, but there is no reason to not take the medication at all.
Mothers who have had a surgical birth need the extra rest that the pain medications provide. By the time your milk is fully in you may find that you don’t need as much medication as you did immediately after surgery.
Hope that helps 🙂
* Drugs containing Oxycodone: Percocet, OxyContin, Roxicodone, Percocet 5/325, Percocet 10/325, Endocet, Roxicet, Percocet 7.5/325, Percodan, Tylox, Xartemis XR, OxyIR, Targiniq ER, Oxyfast, Percocet 10/650, Percocet 7.5/500, Percocet 2.5/325, Magnacet, Primlev, Oxecta, Percolone, Roxicodone Intensol, Dazidox, Xolox, Roxilox, Combunox, Roxiprin, Endodan, M-Oxy, Oxydose, Narvox, Oxycet, ETH-Oxydose, Endocodone, Perloxx, Percodan-Demi.
** Drugs containing Propoxyphene: Darvocet-N 100, Darvon, Darvocet-N 50, Darvocet A500, Wygesic, Balacet, Propoxyphene Compound 65, Darvon-N, Propacet 100, Trycet, PP-Cap, Darvon Compound-65, PC-CAP, Darvon Compound 32