Paracetamol when breastfeeding a baby: dosages

Paracetamol is a very popular medicine used to treat not only adults but also children and is available in the medicine cabinet of almost every family. It is rare to treat a cold without it. Viruses, acute respiratory infections, various symptoms associated with pain, and nursing mothers are not spared. The question arises, how to help yourself without harming the child? Can paracetamol be used while breastfeeding?

Indications Paracetamol for breastfeeding

Although paracetamol does penetrate into breast milk, if you do not exceed the recommended doses and take it for a short period of time (1-3 days), it will not have a negative effect on the child. [ 1 ] Stopping breastfeeding during treatment is not the best option, since switching to bottle feeding can cause refusal to breastfeed in the future, because it is easier to get food this way, and children are very "adaptable".

In what cases should paracetamol be used during breastfeeding? The reason for using the medicine is the woman's poor health, which prevents her from fulfilling her maternal duties, namely:

• high temperature in infectious and inflammatory diseases;
• severe headache and toothache;
• neuralgia;
• muscle pain (myalgia);
• lactostasis - blockage of the milk duct, causing an increase in temperature. [ 2 ]

Release form

Due to the drug's particular popularity and its relative safety, paracetamol is produced in various forms and dosages:

• tablets;
• capsules;
• syrups for children;
• rectal suppositories.

A nursing woman can also use children's Nurofen. Its active ingredient, ibuprofen, inhibits the production of prostaglandins, which are responsible for temperature and pain.

Pharmacodynamics

The main characteristics of paracetamol are its antipyretic effect, analgesic, and to a lesser extent anti-inflammatory. This occurs due to the suppression of the excitability of the thermoregulation center, biologically active substances responsible for pain receptors, and inflammation mediators. [ 3 ]

Pharmacokinetics

The drug is absorbed by the mucous membrane of the upper intestine, through which it enters the blood and all cells of the body, concentrating to the maximum 30-40 minutes after administration. It is metabolized in the liver, excreted through the kidneys with a half-life of 1.9-2.5 hours. The antipyretic effect occurs after 2-4 hours. [ 4 ], [ 5 ]

Dosing and administration

Some forms and dosages are designed specifically for children, which indicates the safety of use in children of the youngest age. For this, there are suppositories and syrups. For older children from 6 to 12 years old who can swallow tablets, they can be used. [ 7 ]

Because of the different dosages, it is best to use their weight or volume in liquid forms. There are different norms for different age groups. [ 8 ]

The tablets are taken 1-2 hours after meals 3-4 times a day and washed down with plenty of liquid:

Age (years)	Single dose	Maximum daily dose
3-6	15 mg per kg of weight	60 mg
6-12	25-50 mg	1-2 g
12 and up	0.5-1.5 g	3-4 g

Rectal suppositories have the same frequency of use:

Age (years)	Single dose	Maximum daily dose
1 month - 3 years	15 mg per kg of weight	60 mg
3-6	25-50 mg	1-2 g
6-12	50 mg	2 g
12 (over 60 kg) and older	75- 100 mg	3-4 g

Syrups:

Age	Single dose (ml)	Frequency of administration per day
2-3 months	2.5	2 doses per day
3-6 months	2.5-5	4 times
6-24 months	5	4 times
2-4 years	7.5	4 times
4-8 years	10	4 times
8-10 years	15	4 times
10-12 years	20	4 times
Children weighing over 60 kg and adults	20-40	4 times

What dose of the drug is safe during breastfeeding? It should not exceed the permissible therapeutic dose for adults. In addition, you should try to limit the treatment to 2-3 days, and you can leave the temperature below 38°. It is best to take paracetamol after feeding the child, until the next time its concentration in the body will decrease.

Contraindications

Paracetamol is contraindicated in case of allergy to the components of the drug, in case of serious liver and kidney diseases. Suppositories are not used if the rectal mucosa is inflamed.

Side effects Paracetamol for breastfeeding

When used in treatment, paracetamol may cause side effects, including decreased myocardial contractility, development of anemia, renal colic, pain in the stomach, nausea, allergic reactions: rashes on the body, itching, swelling. [ 6 ]

Overdose

Overdose leads to liver damage and this will certainly affect the health of the child. [ 9 ] If this happens, it is necessary to stop feeding and wash the woman's stomach. In case of severe symptoms (nausea, vomiting, abdominal pain, dizziness) call an ambulance. [ 10 ]

Interactions with other drugs

Anticonvulsants and other anti-inflammatory drugs increase the toxic effect of paracetamol on the liver. Simultaneous long-term treatment with salicylates can cause the development of a malignant process in the kidneys and bladder. Combining it with alcohol provokes an exacerbation of pancreatitis. Paracetamol reduces the effectiveness of diuretics. The use of Paracetamol with Ibuprofen reduced the temperature in young children faster than paracetamol alone. [ 11 ]

Storage conditions

Paracetamol is stored in the usual conditions for any medicine: at a temperature not exceeding +25°C in a dark place (suppositories - +15°C). An opened bottle of syrup is suitable for use for 30 days.

Shelf life

Paracetamol is valid for 3 years from the date of manufacture, suppositories - 2 years.

Analogues

If it is impossible for some reason to take paracetamol, it can be replaced with analogues, although some of them are not entirely desirable during breastfeeding, as is warned in the instructions. Only a doctor can assess all the health risks and make appointments.

• Viferon - vaginal suppositories, the active substance of which is interferon and tocopherol acetate. Treats acute respiratory viral infections, flu, pneumonia, intrauterine and urogenital infections; [ 12 ]
• Nurofen is a nonsteroidal anti-inflammatory drug, effective in inhibiting the synthesis of prostaglondins. Available in tablets and suspension for children;
• Amoxiclav is an antibacterial drug aimed at gram-positive and gram-negative microorganisms; [ 13 ]
• amoxicillin is an antibiotic used for inflammation of the ENT organs, respiratory, biliary tract, and genitourinary system;
• analgin - a painkiller. Reduces or eliminates pain of various origins, reduces temperature during fever;

Analgin (Dipyrone) is not approved for sale in the United States by the U.S. Food and Drug Administration or in Canada and many European countries due to its adverse reactions, including agranulocytosis. However, it is widely used in other countries during labor and lactation. Following maternal administration, Analgin and its metabolites appear in breast milk in fairly large quantities. It is detectable in the blood and urine of breastfed infants and may cause pharmacological effects in breastfed infants. One case of cyanotic episodes in a breastfed infant was associated with Analgin in breast milk. The drug and metabolites are excreted from breast milk within 48 hours after administration, so it is not recommended to breastfeed the infant for 48 hours after the last dose of the drug.[ 14 ]

• arbidol - an antiviral and immunomodulatory agent, effective against influenza viruses A and B, in the complex therapy of bronchitis, pneumonia (contraindicated during lactation!);
• Activated carbon is a completely safe drug, but it can only help with stomach pain.

Reviews

Paracetamol is a drug that, according to reviews, nursing mothers trust. No matter how hard a woman tries to avoid taking medications, she has too many responsibilities during this period, so she has to look for ways to ease her condition during illness. A reasonable approach to treatment will not harm the baby.