Safe Pain Relief During Breastfeeding: What You Can Take

Published on: November 15, 2025

For postpartum parents who are breastfeeding and desperate for reliable pain relief: you want something that actually works, won’t harm your baby, and won’t derail recovery. You’re juggling sleep deprivation, sore C‑section or perineal pain, plugged ducts or mastitis, and the stress of making the right medication choice—fast. Our lactation-savvy clinicians and pharmacists can help sort through safe options (and do it without judgment), so you can feel better and keep feeding your baby confidently.

What pain relievers are safe while breastfeeding?

Short answer: acetaminophen (paracetamol) and ibuprofen are first‑line choices for most breastfeeding people. They pass into breastmilk in very small amounts and are not expected to cause harm when taken at standard doses. Naproxen and other NSAIDs may also be used in many cases. Opioids can be used short term but need careful monitoring. Avoid routine use of aspirin unless your provider tells you otherwise.

Why? Because these drugs either have low milk transfer or are poorly absorbed by infants—so exposure is minimal. But every medication choice should consider the specific situation (newborn age, baby’s health, maternal liver/kidney function, other meds).

Acetaminophen: is it safe and how much?

Yes—acetaminophen is widely regarded as safe during breastfeeding. Typical dosing for adults is 325–1,000 mg every 4–6 hours as needed, with a commonly recommended maximum of 3,000 mg per day for routine use (some clinicians allow up to 4,000 mg under close supervision, but stay conservative if you have liver disease or drink alcohol frequently).

There’s no need to “pump and dump” after taking acetaminophen. Watch your baby for unusual sleepiness or feeding changes—but serious effects are extremely unlikely at routine doses.

Ibuprofen: can I take it while breastfeeding?

Yes—ibuprofen is another safe choice and often preferred for postpartum inflammation (especially after C‑section or musculoskeletal pain). Standard OTC dosing is 200–400 mg every 4–6 hours, max 1,200 mg/day without medical supervision (doctors sometimes use up to 2,400 mg/day for short periods).

Ibuprofen has low levels in breastmilk and is poorly absorbed by infants—so it’s low risk. It also helps with inflammation and swelling, which acetaminophen doesn’t treat as well.

Naproxen and other NSAIDs

Naproxen (220 mg every 8–12 hours, typical OTC dose) is used by many breastfeeding parents and is considered acceptable short term. But naproxen sticks around longer in the body than ibuprofen, so clinicians sometimes prefer ibuprofen for very young infants. Use naproxen cautiously if your baby was premature, medically fragile, or if you’re using other blood‑thinning drugs.

What about aspirin?

Aspirin is generally avoided unless a specific medical reason exists. Low‑dose aspirin for cardiac reasons is sometimes continued under medical supervision, but routine use for postpartum pain isn’t recommended because of bleeding risk and potential infant exposure (especially if baby is ill or preterm).

Can I take opioid painkillers while breastfeeding?

Short answer: sometimes, but with caution. Opioids like morphine, oxycodone, and hydromorphone can be prescribed after surgery (for example a C‑section), but they should be used at the lowest effective dose for the shortest time possible.

There’s a particular problem with codeine and tramadol—some people metabolize these into much higher levels of active opioid (they’re “ultra‑rapid metabolizers”), which can cause dangerous sedation and slowed breathing in the breastfed baby. For that reason many clinicians avoid codeine and tramadol in breastfeeding parents.

If you need an opioid: use the minimum amount, watch the baby for excessive sleepiness, slow breathing, difficulty waking, or poor feeding, and call your pediatrician immediately if you see those signs. Also ask your prescribing clinician about a safer alternative or a genetic/metabolism test if codeine is being considered.

Do I need to stop breastfeeding or “pump and dump” after taking pain meds?

Usually no. Most common pain meds (acetaminophen, ibuprofen, naproxen) don’t require any interruption of breastfeeding. Opioids don’t automatically mean you must stop, but they do require closer monitoring—no routine pump‑and‑dump.

Why? Because only a small fraction of the mother’s dose reaches milk, and infants ingest just a small portion of that. Pumping and dumping doesn’t speed removal of the drug from your plasma—so it’s rarely helpful. The main reason to pause breastfeeding would be clear signs of infant sedation or if your prescriber tells you to stop for a specific medication with documented risks.

How do medications get into breastmilk and how much reaches the baby?

Medications move into milk based on chemical size, solubility, protein binding, and maternal blood levels. But here’s the practical rule: most pain meds are either large, highly protein‑bound, or rapidly cleared—so only tiny amounts end up in milk. Which is why acetaminophen and ibuprofen are considered low risk.

That said, newborns (especially preterm babies) have immature liver and kidney function, so they clear drugs more slowly. That’s why clinicians are more conservative with very young or medically fragile infants.

Non‑drug pain relief options for postpartum recovery

Medications are only one tool. Combine them with non‑drug strategies and you’ll often need less medication.

• Cold packs for swelling, heat for muscle tension (20 minutes on/off).
• Sitz baths for perineal pain and hemorrhoids (warm water, 2–3 times daily).
• Breastfeeding position changes (try football hold or side‑lying to reduce nipple trauma).
• Pillow support for C‑section incisions during coughing and feeding (hug a pillow—seriously helpful).
• Topical anesthetics or numbing sprays for localized perineal pain—ask your clinician which product is safe for breastfeeding.
• Gentle pelvic floor physiotherapy and perineal massage (once cleared by your provider).

Specific postpartum scenarios: what to take

Mastitis or plugged ducts

Over‑the‑counter ibuprofen plus continued, frequent breastfeeding or pumping is the usual approach (ibuprofen helps pain and inflammation). Antibiotics are used when infection is present—most commonly prescribed antibiotics are compatible with breastfeeding (like dicloxacillin or cephalexin), but always check with your prescriber or pharmacist.

C‑section pain

Ibuprofen plus acetaminophen in scheduled, alternating doses can provide excellent pain control and reduce the need for opioids. For example: acetaminophen 1,000 mg every 6 hours (max 3,000 mg/day) plus ibuprofen 400 mg every 6 hours as needed (stay within daily limits). Use of short opioid course for breakthrough pain is okay—again, lowest dose and shortest duration.

Perineal pain (tears or episiotomy)

Sitz baths, topical numbing agents, and ibuprofen/acetaminophen are first‑line. For severe pain, short opioid prescriptions may be given—monitor baby closely if you use them.

Dental pain or procedures

Ibuprofen plus acetaminophen is often enough. For procedures requiring stronger analgesia, coordinate with your dentist and pediatrician; most local anesthetics and short opioid courses are compatible with breastfeeding when monitored.

 

 

When should I call my provider or the pediatrician?

• If your baby becomes unusually sleepy, hard to wake, feeds poorly, or has slow breathing after you take a medication.
• If pain is uncontrolled by recommended OTC medications and non‑drug measures.
• If you were prescribed codeine or tramadol—ask about alternative options immediately.
• If you have liver disease, kidney disease, or are taking multiple medications that might interact.
• If your baby was born preterm or has medical issues—extra caution is needed.

Practical tips for safe pain management while breastfeeding

• Keep a medication list (include dose and time) so your pediatrician or pharmacist can advise quickly.
• Use the lowest effective dose for the shortest period necessary—this reduces baby exposure and side effects.
• Prefer medications with short half‑lives (acetaminophen, ibuprofen) over long‑acting ones when possible.
• Avoid codeine and tramadol unless other options are exhausted and you’ve discussed metabolic risk with your clinician.
• Talk to a lactation consultant if nipple pain is the issue—often technique fixes the problem and reduces need for meds.
• If you’re prescribed antibiotics, ask whether they’re breastfeeding‑compatible (most are) and about potential effects on your milk supply or baby’s gut.

How our team can help

If this feels like too many choices—and honestly, who has time for research between feedings—our lactation consultants and pharmacists can review your meds, recommend the safest options for your situation, and set up a monitoring plan for your baby. We help you balance effective pain relief with breastfeeding goals so you can focus on recovery and your newborn (we do the worrying about drug interactions).

Quick summary: safe pain relief checklist

• First choices: acetaminophen and ibuprofen (safe, effective, low milk transfer).
• Naproxen: acceptable short term but use more cautiously in newborns.
• Avoid aspirin for routine pain relief unless medically required.
• Opioids: short courses only, avoid codeine and tramadol when possible, monitor baby closely.
• Pump and dump is rarely necessary—talk to your clinician instead.
• Combine meds with non‑drug measures (sitz baths, ice/heat, positioning) for better recovery.

Want personalized advice? Schedule a quick consult with our team—tell us your pain level, what you’ve already tried, and your baby’s age and health, and we’ll outline a safe plan. Real talk: you don’t have to tough it out alone, and relief shouldn’t mean risking your baby’s safety.