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Breastfeeding with Head Pain Disorders

Whats safe, whats not and how to find out.

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Updated: August 1, 2005

New mothers who experience migraine and other head pain disorders are often reluctant to take a medication to prevent or abort their head pain because they are afraid the medication may pass from their breastmilk to the baby.

Not only during World Breastfeeding Week, but throughout the year, the World Alliance for Breastfeeding Action and La Leche League International are two of many organizations that promote breastfeeding education and support. Helping mothers breastfeed during illness and medication use is one area of focus for breastfeeding education.

Gina is a breastfeeding mother who suffers from Migraines. She’s 42 and has had Migraines since she was 18. Gina used to treat her Migraines with pain pills or Imitrex, but once she became pregnant and a nursing mother, Gina sought other ways to treat her Migraines.

Gina currently treats her Migraines with what she calls a “cocktail of Tylenol, Sudafed and caffeine; a good, strong latte from Starbuck’s. Usually I have to repeat this over two days.” Gina adds that even if she decided to use traditional medicines, she would have to stay away from anything that would sedate her because she still has to care for her children.

Gina says that while she is still nursing her two-year-old, she would prefer a treatment more natural or homeopathic in nature, but for right now she goes with what works. She says if she wasn't a nursing mother, she would probably go back to Imitrex for treating her Migraines.

Many breastfeeding mothers assume that Migraine and other headache medications can not be taken while nursing. Actually, with information about the drugs used and help from her doctor, a breastfeeding mother may decide that she does want to treat her Migraines or headaches medically.

"Medications and Mothers’ Milk,"¹ by Thomas W. Hale, R.Ph., Ph.D., associate professor of Pediatrics and associate professor of Pharmacology at Texas Tech University School of Medicine in Amarillo, Texas, is recognized as one of the best resources for understanding how medications affect a breastfeeding mother’s milk. His reviews of hundreds of medications contain information known in current scientific literature. This book contains information such as:

  • the half life of a drug (how long it takes the body to get rid of half the dosage of medication taken)
  • time to peak drug concentration in the mother’s blood plasma
  • molecular weight of the drug (a drug with a molecular weight at 200 or higher has less chance of entering breastmilk than drugs lower than 200)
  • oral bioavailability (the ability of a drug to reach systemic circulation after oral administration; listed as a percent, how orally bioavailable the drug is)
  • and pediatric half-life

This information can help the breastfeeding mother and her physician decide if the mother wishes to take the Migraine or headache medication and continue breastfeeding. Triptans such as Imitrex, Zomig, Maxalt, Amerge, Axert, Frova and Relpax are medicines commonly prescribed as Migraine abortives. Many doctors would suggest a mother wean her baby if she’s going to take these medications, or “pump and dump,” – meaning the mother should pump her breastmilk and throw it away while feeding her baby formula or previously pumped breastmilk. But with information from Medications and Mothers’ Milk, it’s possible for the mother to decide to continue to breastfeed while taking a triptan.

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