Ketoprofen
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Bezpieczny. Można stosować. Minimalne ryzyko dla karmienia piersią i dziecka.
Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID). Oral, rectal, intramuscular, intravenous and topical administration every 6 to 12 hours.
It is excreted in breastmilk in clinically negligibe amounts (Jacqz-Aigrain 2007) and expert authors consider it compatible with breastfeeding (Hale, Davanzo 2014, Jacqz-Aigrain 2007, Janssen 2000, Nice 2000). Its high percentage of protein binding explains the very small transfer to milk observed.
In a French pharmacovigilance study, several possible cases, unconfirmed, were found of the implication of ketoprofen in certain adverse effects in the infant (Soussan 2014). Its pharmacokinetics makes its involvement unlikely.
Most non-steroidal anti-inflammatories may increase jaundice, so it is preferable to avoid them during the neonatal period in mothers of infants with jaundice. (Janssen 2000)
TOPICAL USE: The small dose and the low plasma absorption of most topical dermatological preparations make transfer to breastmilk in significant amounts unlikely. Dermal bioavailability is 5%. (AEMPS 2016)
Ibuprofen
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Bezpieczny. Można stosować. Minimalne ryzyko dla karmienia piersią i dziecka.
A non-steroidal anti-inflammatory indicated in the treatment of fever, pains, rheumatoid arthritis and other rheumatic complaints.
Oral, intravenous and topical administration (cutaneous or vaginal), every 6 to 8 hours.
Its pharmacokinetic data (high percentage of protein binding, acidic character and short half-life) explain the tiny or zero transfer of milk observed.(Rigourd 2014, Walter 1997, Townsend 1984, Albert 1984, Weibert 1982) No problems have been observed in infants whose mothers were taking it. (Walter 1997, Ito 1993, Weibert 1982)
A medication commonly used in pediatrics. Its use is authorized from 6 months of age. The dose that an infant can receive through breastmilk is hundreds of times inferior to the therapeutic dose given to an infant. (Rigourd 2014, Walter 1997)
American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)
List of essential WHO medications: compatible with breastfeeding. (WHO/UNICEF, 2002)
Several medical societies, experts and expert consensus consider it compatible with breastfeeding.(Sammaritano 2020, Parikh 2018, Reece 2017, Bordini 2016, Noviani 2016, Davanzo 2014, Sachs 2013, Worthington 2013, Hutchinson 2013, Rowe 2013, Amir 2011, Chen 2010, Risser 2009, Østensen 2007, Spigset 2000 , Janssen 200, Nice 2000, Mitchell 1999, Goldsmith 1989, Needs 1985)
It is regarded as the analgesic of choice for breastfeeding mothers. (Worthington 2013, Østensen 2007, Nice 2000)
Bardzo niskie ryzyko.
Bezpieczny. Można stosować. Minimalne ryzyko dla karmienia piersią i dziecka.
Analgesic and antipyretic. Indicated in the treatment of pain and fever. It has a weak anti-inflammatory effect. Oral, intravenous and rectal administration, every 4, 6 or 8 hours.
It is excreted in very small quantities in breast milk. (AEMPS 2017, GSK 2015, Notarianni 1987, Bitzén 1981, Findlay 1981, Berlin 1980, Hurden 1980) The amount that the infant can receive through breast milk is much lower than the usual pediatric dose.(Lee 1993)
No problems have been observed in infants whose mothers were taking it,(AEMPS 2017, Ito 1993) except for one case of mild dermatitis in an infant. (Matheson 1985)
No association has been observed between maternal paracetamol use and neurodevelopmental disorders in infants (autism spectrum disorder, ASD, attention deficit/hyperactivity disorder,ADHD).
The urinary levels of infants have been undetectable. (AEMPS 2017, Berlin 1980) Other authors have measured insignificant levels in urine, but only paracetamol, not their metabolites as in adults.(Notarianni 1987)
The hepatotoxicity of paracetamol is lower in newborns and small infants due to hepatic immaturity: the low levels of specific cytochrome P-450 enzymes hinder the conversion of the drug into its toxic metabolites. (Reece 2017, Sachs 2013)
Medication commonly used in Pediatrics, with authorized use in neonates, including premature infants.
American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)
List of essential medicines WHO: compatible with breastfeeding. (WHO / UNICEF, 2002)
The manufacturer (AEMPS 2017, GSK 2015) and expert authors and medical associations consider it compatible with breastfeeding. (Reece 2017, Davanzo 2014, Rowe 2013, Worthington 2013, Sachs 2013, Amir 2011, Zrour 2010, Chen 2010, Østensen 2007, Nice 2004, Bannwarth 2003, Bar-Oz 2003, Janssen 2000, Nice 2000, Spigset 2000, Mitchell 1999, Bodley 1997, Lee 1993, Bitzen 1981, Berlin 1980)