Medications while pregnant or breastfeeding

Back pain, headaches, aching legs – these are all common ailments which can become even more prevalent when you’re pregnant or mum to a little baby.

But many mums and mums-to-be are too scared to take anything that will relieve the pain. Well, be worried no longer, says Dr Debra Kennedy, Director of MotherSafe, a free NSW counselling service for NSW women and their healthcare providers who are concerned about exposure – such as medicines – during pregnancy and breastfeeding.

She says pregnant and breastfeeding women should not suffer pain unnecessarily as there are treatment options available to them – in fact, leaving pain untreated can actually do more harm than good.

“Inadequately managed persistent pain can result in depression and anxiety. These may impact on a woman’s physical and psychological wellbeing and can potentially have an adverse effect on her pregnancy,” Dr Kennedy says.

She advises pregnant and breastfeeding women to talk to their health professionals about the risks of treating pain versus not treating it.

The pros and cons of over-the-counter pain relievers

Paracetamol

Paracetamol is the most widely used pain reliever in Australia, particularly by pregnant women. Although paracetamol readily crosses the placenta, at recommended doses it does not appear to increase the risk of birth defects or other adverse outcomes of pregnancy.

The risks: Taking more than the recommended dose of paracetamol may cause harm to the mother or baby’s lives or kidneys.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Aspirin and other NSAIDs such as ibuprofen, are not expected to cause structural birth defects or malformations, or other adverse outcomes such as preterm delivery or low birth weight.

The risk: NSAIDs should not be used in the third trimester without specialist advice. They may harm the baby during this stage or pregnancy by closing one of their blood vessels too early, raising blood pressure in their lungs, and delaying labour and birth. High doses of these medicines in the third trimester may also impair the function of the baby’s kidneys. NSAIDs can also increase the risk of bleeding complications in the baby or mother.

Codeine

Opioid pain relievers such as codeine have not been associated with an increase in birth defects or miscarriage.

The risk: The main concern is that persistent use may lead to dependence and tolerance in the mother, with resultant drug withdrawal effects in the newborn. Use of opioid pain relievers may also impair the baby’s lung function.

 

What MotherSafe advises

“We recommend paracetamol to treat fever and pain during pregnancy,” says Dr Kennedy. “Codeine or another opioid analgesic can be added to treat more severe pain.

“Inadvertent use of non-steroidal anti-inflammatory medicines in the first trimester is not usually harmful but these medicines should not be used in the third trimester.”

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