Pain Relief - What’s Safe to Take When You’re Breastfeeding?

Apr 7

As you recover after birth, you might experience a level of mild or fairly severe pain. Caesarean sections and significant tears come with a period of recovery that can be quite uncomfortable and you might also experience pain as your uterus contracts during the postpartum period, especially if it’s your second baby. Pain is of course unpleasant, stops you getting that oh so precious sleep and it can interfere with hormone balance. You just don’t need it!

But you might be wondering if you need to take care of what you are taking while breastfeeding so that you don’t pass anything dangerous onto your baby. While this care is definitely a good idea and it’s always worth checking with your midwife, the good news is, there are plenty of options!

The pain relief most typically recommended in the postpartum period and safe to take while breastfeeding:

Over the counter (though your midwife will be able to provide a prescription):

Ibuprofen
Paracetemol

Prescription:

Co-dydramol
Dihydrocodeine
Diclofenac

You do of course need to be careful of dosage and you might be struggling to keep up with the organisation of managing your pain relief. Especially after a caesarean when you have a few different prescriptions. You’re trying to remember when you fed your baby, when they last slept, when you changed their nappy and on top of that, taking care of yourself can go out of the window. One thing you can do is get your partner or someone else in the household to be in charge of your medication. Reduce that mental load from the very beginning and ask them to set reminders on your phone if they are going out.

Here are the guidelines on 6 different types of pain relief and when you can take them.

Paracetamol - four times a day every 4-6 hours (eg. 7am - 12pm - 6pm - 10pm)
Ibuprofen - three times a day roughly every 8 hours (eg. 7am - 3pm - 10pm)
Co-dydramol - cannot be taken with paracetamol, take four times a day every 4-6 hours, take at the same time as you would take paracetamol (because this is instead of the paracetamol)
Dihydrocodeine - cannot be taken with co-dydramol - one tablet (30mg) four times a day every 4-6 hours.
Diclofenac is a suppository, in the same family as ibuprofen and cannot be taken with ibuprofen. It lasts for 12 hours. It can be more effective as it is administered closer to the site. It’s not commonly subscribed as generally ibuprofen is sufficient, but this is an option you can request.
Co-dydramol, dihydrocodeine and diclofenac are stronger painkillers than the standard ibuprofen or paracetamol. For this reason, doctors and midwives advise only one of these for the first three to five days. Normally by this time, even with a third or fourth degree tear or a caesarean section, you will not need the stronger painkiller.

You may find that you are prescribed laxatives alongside co-dydramol or dihydrocodeine, as well as iron tablets. This is because opiates and iron tablets can cause constipation. Laxatives can also help if you’ve had a third or fourth degree tear or caesarean, as straining to push open your bowels in these cases might cause pain or discomfort.

The pain that can come with postpartum recovery can be upsetting, particularly if you’ve had a difficult pregnancy and were looking forward to feeling “back to normal” in your body after birth. Remember though, this period doesn't last long and your body will recover eventually. Just make sure you’re keeping on top of your medicine, taking the right pain relief and giving yourself plenty of time and space to rest and heal.

This is a tiny snippet of the information you’ll find in The Postpartum Pack, our fully comprehensive online course to guide you through the fourth trimester. This course also comes with a free 15 minute call to one of our midwives and access to a private peer support group on Facebook for ongoing solidarity with other parents.