Is Aspirin safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Aspirin. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
One case report of metabolic acidosis was caused by salicylate in a 16-day old breastfed infant whose mother was taking aspirin 650 mg every 4 hours for arthritis.[ 9 ] However, there was no measurement of salicylate in maternal serum or milk and it is unclear whether the infant had received any salicylate directly. Thrombocytopenia, fever, anorexia and petechiae occurred in a 5-month-old breastfed infant 5 days after her mother started taking aspirin for fever. One week after recovery, the infant was given a single dose of aspirin 125 mg and the platelet count dropped once again. The original symptoms were probably caused by aspirin or salicylate in breastmilk.[ 10 ] Hemolysis after aspirin and phenacetin taken by the mother of a 23-day-old, glucose-6-phosphate dehydrogenase (G6PD) deficient infant was possibly due to aspirin in breastmilk.[ 11 ] In a telephone follow-up study, mothers reported no side effects among 15 infants exposed to aspirin (dosages and infant ages were unspecified) in breastmilk.[ 12 ]
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
Aspirin is rapidly metabolized to salicylate after ingestion, so most studies have measured salicylate levels in breastmilk after aspirin administration to the mother; however, some studies have not measured salicylate metabolites in breastmilk that may be hydrolyzed in the infant's gut and absorbed as salicylate.[ 1 ] Maternal Levels. A woman taking aspirin 4 grams daily for rheumatoid arthritis was nursing her 5 kg infant (age not reported). Salicylate was not detectable ( 50 mg/L) in breastmilk with the relative insensitive assay used.[ 2 ] Six nursing mothers who were 2 to 8 months postpartum (average 5 months) were given aspirin doses of 500, 1000 and 1500 mg of aspirin orally on 3 separate occasions. Peak breastmilk salicylate levels were 5.8 mg/L, 15.8 mg/L, and 38.8 mg/L, respectively. The time of the peak levels occurred between 2 and 6 hours after ingestion, with little variation in levels over time. The disproportionate increase in milk levels as the dose increased was attributed to nonlinear metabolism and protein binding.[ 3 ] Milk and blood levels of salicylate and its metabolites were determined in 8 lactating women following oral administration of 1 gram of aspirin. Peak salicylic acid milk levels averaging 2.4 mg/L occurred 3 hours after the dose. Milk contents of salicyluric acid were greater than those of salicylic acid; a mean peak level of 10.2 mg/L was reached after 9 hours, and the average level was 4.4 mg/L at 24 hours after the dose. Total salicylate and metabolite levels were 5.1 mg/L at 3 hours, 9.9 mg/L at 6 hours, 11.2 mg/L at 9 hours and 10.2 mg/L at 12 hours after the dose. Acid labile conjugates were less than 0.2 mg/L.[ 4 ] Using an average salicylate plus salicyluric acid level over the first 12 hours, a fully breastfed infant would receive an average of 9.4% of the maternal weight-adjusted dosage. Two women given aspirin 454 mg orally had peak salicylate milk levels of about 1 mg/L at 1 hour after the dose. The authors estimated th
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.