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I am a new mum with a 2 month old baby and during pregnancy I started to have problems with my hands due to retained water. In particular my thumbs became painful and instead of the problem going away after giving birth it actually got worse. The symptoms are as described by De Quervain's Tendonitis. So far I have had two treatment options offered to me by medical practitioners: surgery or acupuncture. I'm sure both are effective however I don't want surgery and acupuncture is going to be expensive. My internet research has found that ketoprofen phonophoresis was effective and safe for pregnant and breastfeeding ladies for this ailment (The Internet Journal of Orthopedic Surgery; Relieving Tenderness Over Anatomical Snuff Box Through Penetration Enhancing Vehicles). I have also read that Ibuprofen taken by mouth passes into breast milk in such small quantities that it is unlikely to harm the baby, hence topical ibuprofen is also unlikely to be harmful. However, on the information leaflet of the Dolobene Ibu gel (Ibuprofen) it says do not use when breastfeeding. It is likely that a Ketoprofen gel will say the same on its safety sheet. Given this information it seems that Ketoprofen would be a more effective treatment than Ibuprofen but may not be recommended given I'm breastfeeding. I would really appreciated your professional opinion as going backwards and forwards between doctors the last month is really distressing while carrying a baby with sore hands. Would it be reasonable to use a Ketoprofen topical gel for a short time to reduce the inflammation and heal my hands? Thanks!
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Hi, thanks for your post.
We give ORAL ketoprofen an L2 (out of 5) ("Probably safe") with regards to its lactation safety. It is commonly used to treat postpartum pain in breastfeeding women with no problems. A small study of patients receiving ketoprofen phonophoresis for knee pain demonstrated "negligible" drug levels in the plasma. It is reasonable to conclude that the topical treatment is even safer than the oral.
Remember to clean your hands and breasts thoroughly before feeding. You do not want your baby to swallow or absorb any residual gel on your skin. You should also watch your baby for stomach and intestinal problems; the most common ketoprofen side effect in babies is the same as in adults.
I hope this treatment works for you. De Quervain's can be really miserable.
Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519
-James Abbey, MD
The following references may be useful to your physician if he or she needs more information:
Cagnie B, Vinck E, Rimbaut S, Vanderstraeten G. Phonophoresis versus topical application of ketoprofen: comparison between tissue and plasma levels. Phys Ther. 2003;83(8):707-12.
Jacqz-Aigrain E, Serreau R, Boissinot C, Popon M, Sobel A, Michel J, Sibony O. Excretion of Ketoprofen and Nalbuphine in Human Milk During Treatment of Maternal Pain After Delivery. Ther Drug Monit. 2007 Dec;29(6):815-818.
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