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Hello. I have a daughter 26 months old that still breastfeeding and I am pregnant. My doctor suggested that I should take acetylsalicylic acid 160 mg one pill a day because of preeclamspia risk. My daughter nurses 5 -6 times a day. Is that safe for her And after how many hours can I breastfeed after taking the pill?
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Xaratir,
Aspirin (acetylsalicylic acid) is rated an L2-limited data-probably compatible. The amount that transfers into breast milk is 2.5-10.8% of your dose. We recommend waiting 2-3 hours after a dose to nurse. If your infant has a known viral illness such as the chickenpox or flu you may want to wait longer to be cautious (24 hours). "While the direct use of ASA in infants and children has been associated with Reye syndrome, the use of the 81 mg/day dose, or even a single 325 mg dose, in breastfeeding mothers has not been linked to an increased risk of this syndrome in the infant. Unfortunately we do not presently know of any specific dose-response relationship between aspirin and Reye syndrome other than in older children where even low plasma levels of ASA were implicated in Reye syndrome during viral syndromes such as flu or chickenpox. Lastly, ASA is rapidly metabolized to salicylic acid. ASA is almost completely gone in 2 hours after an oral dose. A brief wait of 2-3 hours after administration would virtually eliminate all ASA transfer to milk." (Medications and Mothers' Milk database, Dr Thomas Hale PhD). Monitor for rare-bruising on the skin, blood in urine or stool.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519 -
Xaratir:
We just finished and published data on 81 mg aspirin, and 325 mg aspirin ONCE daily. See below. Very very little in human milk.
Tom Hale Ph..D.
In a new study in seven breastfeeding mothers consuming 81 mg/day, milk samples were collected at 0, 1, 2, 4, 8, 12, and 24 hours.[6] Acetylsalicylic acid levels were below the limit of quantification (0.61 ng/ml) in all the milk samples, whereas salicylic acid was detected at very low concentrations. The average concentration of salicylic acid observed was 24 ng/ml and the estimated relative infant dose was 0.4%. Acetylsalicylic acid transfer into milk is so low that it is undetectable even by highly sophisticated methodology. Salicylic acid does appear in the human milk in comparatively low amounts, which are probably subclinical in infants. In one patient consuming 325 mg/day of aspirin, human milk levels of ASA were comparable with those taking 81 mg, or undetectable (< 0.61 ng/ml). In this patient, the maximum concentration of SA was observed as 744.6 ng/ml, which peaked at 1 hour. The area under the curve was 2579 ng.hr/ml and the average concentration estimated was 107.4 ng/ml. The relative infant dose calculated was 0.45% at this dose. Thus, the daily use of an 81-mg dose or 325 mg/day of aspirin should be considered safe during lactation.
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