Aspirin

[lorirn]

I am a NICU based lactation consultant and have a mom who delivered a 33 weeker 6 days ago. She has been on 81 mg aspirin a day due to having had a heart attack some time ago. She did talk to her cardiologist today and was told she could stop the aspirin. The neonatologist had her throw away all of her milk up until today. I reviewed the data from Medications in Mothers Milk, researched on here before I told this mom it was ok but advised to see if she could stop. The neonatologist still threw it away. Not sure if that needed to happen. Your thoughts? All the good first colostrum is in the garbage now.
Lori Lindsey RN IBCLC

[admin-james]

I don't think the aspirin itself would have been much of a problem. You know from reading the book that it has a short half-life and transfers poorly into milk. However, the metabolites persist for quite a while longer. If this premature baby is having difficulty clearing them, there is the potential for toxicity here. It seems like the risks could have been more accurately assessed with monitoring of salicylate levels in the baby. My impression of this case is that the benefits of breastfeeding probably outweighed the risks of the aspirin, but it would take more patient and lab data to say for sure.

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-James Abbey, MD

[lorirn]

aspirin

No that does answer my question. do you recommend monitoring those levels now?

[admin-james]

I am expecting salicylate levels not to be a real problem. It would be prudent to get a level at least once (after a few days of breastfeeding) just to demonstrate that these metabolites are not accumulating. Liver and kidney function are essential to eliminating the drug and these values are probably already being documented.