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Breastfeeding Moms Breastfeeding Moms

Question about pain meds

Posted by on May. 1, 2012 at 4:45 PM
  • 5 Replies

Hi ladies,

 I poked around the forum a bit before deciding to ask this, and didn't find anything that really answered my questions. So here goes.

I am having a minor outpatient medical procedure done tomorrow afternoon. It's not anything that requires me to be put under, but they are giving me a combination of pain meds. I am to take one vicodin and one valium after arriving at the doctor's office. They will also be giving me an injection of toradol prior to the procedure. When I talked to the nurse at my Dr.'s office (where I will be having the procedure done) she said that I should pump and dump for 24 hours following the procedure. I was just wondering if anyone knew how accurate these instructions are. With this combination of drugs, should I abstain from breast feeding for longer? Not as long? I'm just not sure.

My biggest concern, aside from the effects of the medication on my daughter, is that she isn't really a bottle baby. She flat out refuses to take one for me, which is understandable. She toys with it when dad or big sister offers it. And, since I'm a SAHM, I haven't really stressed too much up to this point about her taking a bottle. It's never been a big deal to me. I do have a nice supply pumped and frozen, mostly because I was given a nice pump, and I seem to become engorged a lot easier with her than I ever did with my first. So the pump provides relief on occasion, if she's full and I'm still engorged. So the supply of milk isn't a concern for me. Really, my concern is whether or not she'll take a bottle. And 24 hours is a long time to be fighting with her over a bottle. And some of that time, it'll just be me at home. As Dh will be at work, and big sister will be at school.

by on May. 1, 2012 at 4:45 PM
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Replies (1-5):
maggiemom2000
by Ruby Member on May. 1, 2012 at 4:59 PM

You can breastfeed as soon as you are alert/awake enough to safely hold your baby. At that point enough of the meds will be out of your system. You DO NOT need to pump and dump for 24 hours, and you can continue to take pain meds for a few days (even a couple of weeks) as needed for pain following the procedure. Even if you were to be 100% "knocked out" the same is still true.

None of those meds are contraindicated for bfding.

Here's some more info for you:

The following information comes from MEDICATIONS AND MOTHERS’ MILK by Thomas Hale, 2010.  He assigns every drug a lactation risk category:  L1, safest; L2, safer; L3, moderately safe; L4, possible hazardous; and L5, contraindicated. He also lists if a drug has been reviewed and/or approved by the American Academy of Pediatrics (AAP) for use in nursing mothers.  Possible risks to mother and baby are listed as well as possible effect on milk supply.

KETOROLAC (Toradol, Acular)

Listed as L2, safer; Maternal Medication Usually Compatible with Breastfeeding; pediatric concerns: none reported in one study

HYDROCODONE (Lortab, Vicodin, Maxidone)

Listed as L3; not reviewed by the AAP; pediatric concerns: none reported but observe for sedation, apnea, constipation. “Most authors suggest that doses of 5mg every 4 hours or more has minimal effect on nursing infants, particularly older infants. However, no data on hydrocodone levels in milk are available. To reduce exposure to the infant, attempt to feed prior to taking the medication. The half life of the medication is 3.8 hours, it peaks in the blood/milk at 1.3 hours.

VALIUM (Diazepam) L3; AAP: Drugs whose effect on nursing infants is unknown but may be of concern. Pediatric concerns:  Some reports of lethargy, sedation, poor suckling have been found.  “Published data on milk and plasma levels are highly variable and many are poor studies.  The acute use such as in surgical procedures is not likely to lead to significant accumulation.”  The levels of the drug peak in the blood 1-2 hours after taking, and decline significantly after 43 hours.  “The shorter-acting benzodiazepines (lorazepam, alprazolam) are safest during lactation provided their use is short term or intermittent, low dose.”


sreichelt26
by on May. 1, 2012 at 5:03 PM
^^what she said. Norco is given to csection moms, which is Vicodin and Tylenol together.
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Eviesmommy
by on May. 1, 2012 at 5:08 PM

Thank you SO MUCH, Maggiemom! And Thank you, sreichelt26! I had a c-section with both of my girls, and was prescribed vicodin for the pain. So I knew it was pretty safe. I also had a toradol drip for the first day when I was in the hospital with my second. So I knew toradol and vicodin were okay. It was the valium thrown into it that had me concerned. I have zero experience with valium, so I wasn't sure. This makes me feel so much better.

nakisha.aguallo
by on May. 1, 2012 at 5:10 PM
I was given vicodin after I gave birth and they knew I was bfing it did make my son a little drowsy but for the first 48 I was taking 2 every 4 hours (I tore in two spots and my cervix was cut twice prior to delivery). I also took it every 6 hours for a few days after discharge however it was a half to one every six w ibuprofen. His pedi was also fine w it.
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maggiemom2000
by Ruby Member on May. 1, 2012 at 5:13 PM


Quoting Eviesmommy:

Thank you SO MUCH, Maggiemom! And Thank you, sreichelt26! I had a c-section with both of my girls, and was prescribed vicodin for the pain. So I knew it was pretty safe. I also had a toradol drip for the first day when I was in the hospital with my second. So I knew toradol and vicodin were okay. It was the valium thrown into it that had me concerned. I have zero experience with valium, so I wasn't sure. This makes me feel so much better.

Exactly!

Valium is really only a problem with multiple doses. With only one dose it is totally fine.

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