Injectable Imitrex, for example, reaches peak concentration in the mother’s plasma in 12 minutes; the half-life is 1.3 hours. A mother with a Migraine may take this information and discuss with her doctor how to time her baby’s nursing session to make sure the baby receives virtually no exposure to the drug through her breastmilk.
Migraines aren’t the only head pain a new mother might experience. Even though cluster headaches affect more men in general, women also get cluster headaches and need to treat them for relief.
Triptans are also used to treat cluster headaches, but another common class of treatment, ergotamines such asDHE, Migranal, and other ergotamine derivatives, are contraindicated in breastfeeding mothers. Use of either of these medicines may cause ergotism (excessive vomiting and diarrhea) in the infant. However, other treatments, such as inhaled oxygen, may be considered.
Preventive medicines are used to try to cut the frequency, severity and duration of Migraines, clusters and tension headaches. Once again, by using "Medications and Mothers’ Milk," a mother and her doctor can examine the preventives used and may decide if choosing one is safe for the mother and baby.
The choices of drugs that may work best for a breastfeeding mother include:
- a drug with a short half-life (they generally also peak rapidly)
- a drug with a short pediatric half-life
- a drug with a high molecular weight
- a drug that has a low percentage of oral bioavailability
Breastfeeding mothers may be interested in herbal supplements or remedies to treat their Migraines or headaches. It’s important, also, to investigate these preparations; the Food and Drug Administration (FDA) does not regulate herbal supplements and strengths of these supplements vary from brand to brand. Also, just because something is labeled herbal or natural, it’s not necessarily safe for a nursing infant.
If a mother does not wish to use traditional medicines, comfort measures such as lying down in a dark room or using ice or heat on the head can be easy to do with a small infant. Mothers can also use a headache diary to track their Migraines or headaches to see if there is a lifestyle change that will help alleviate head pain.
Chiropractic adjustments or massage therapy are also options nursing mothers can pursue if they wish to avoid taking medicines.
With careful study of Migraine and headache medications and consultation with a doctor, most mothers who experience Migraine or chronic head pain may decide they can safely breastfeed their infants and treat their pain at the same time.
References:
¹ Hale, Thomas W., Medications and Mothers’ Milk, Ninth Edition, 2000 Pharmasoft Publishing
² Texas Tech University School of Medicine, Thomas W. Hale, R.Ph. Ph.D., Associate Professor of Pediatrics "Breastfeeding Pharmacology."
