Pain Management in Breastfeeding Women

I read with great interest the recent article “Pharmacologic Management of Acute Pain in Breastfeeding Women.”1 I believe it was very well written and will lead to a greater understanding by emergency nurses of pain management for breastfeeding women. This is important, as the authors pointed out, given the rise in the number of breastfeeding women and the concurrent rise in ED visits nationwide.

Of note, it is important for health care providers to be able to accurately advise breastfeeding women of their options for treatment so as not to inadvertently cause unnecessary discontinuation of breastfeeding. Prescribing providers often provide overly cautious or inaccurate information on medication use during breastfeeding because drug manufacturers rarely indicate that use of a specific drug while breastfeeding is safe or advisable; in fact, adverse drug reactions in breastfed infants whose mothers receive medication are rare.2

Second, clinician support is vital to the continuation of breastfeeding by postpartum women.3 Emergency nurses can provide encouragement and support to breastfeeding women by helping to educate them on their options for medication use. Pharmacists and lactation consultants are excellent resources for ED staff in regard to precautions in drug selection. The definitive reference, Medications and Mother’s Milk, by Thomas W. Hale, is widely available.4

Given the documented health benefits to women and children that breastfeeding provides, nurses must actively support breastfeeding by providing accurate information and encouragement. Women who seek pain medication while also breastfeeding their children should be taught that there are safe options to manage their pain. This article is an excellent resource for emergency nurses.