NSAIDs reducing milk supply?

[enruf]

In MCH Lactation Clinic (in Sharjah, UAE, 5000 consultations per year), we have noticed that mothers discharged from maternity wards on NSAIDs (ibuprofen, diclofenac, mefenamic acid) have either a delayed lactogenesis phase II, or a tightness in their breasts (sometimes severe engorgement) and the milk is not flowing out. They usually also experience reduced lochia. These symptoms (including lochia) usually resolve within 24 hours of stopping the drug.
Mothers (including colleagues) with older babies also report a decreased in milk supply when taking NSAIDs. Recently a mother spontaneously reported this effect (without being probed), after noticing a sudden decrease in milk supply after taking ibuprofen prescribed by her dentist.

I even tried ibuprofen for a mother with severe oversupply, as pseudoephedreine was causing her too many side-effects. It worked (she was feeling less full, with less need of pumping to comfort), but only for 24 hours.

Has anyone else noticed these effects of NSAIDs? I know it is not reported any where and that these drugs are classified L1, so it's really mind-boggling (and confusing) for us... I've contacted the Drug Information Department in our area, but launching a study takes time and money...

[admin]

enruf:

This is the first time I've ever heard of NSAIDS, particularly ibuprofen, producing a reduction in milk production. I think before we go to far with this suggestion, we need some real data. I will probably initiate a survey of moms who consumed various NSAIDS and see if this is 'real'.

Thanks for the question. Lets dig into this further.

Tom Hale Ph.D.