Paracetamol in breastfeeding: dosage

Paracetamol is a very popular medicine used to treat not only adults but also children and is available in the medicine chest of almost every family. Rarely, the treatment of colds without it. Do not bypass viruses, acute respiratory infections, various symptoms associated with the manifestation of pain, and lactating mothers. The question is how to help yourself without harming the child? Is paracetamol available for breastfeeding?

Indications Paracetamol for breastfeeding

Although paracetamol penetrates into breast milk, but if you do not exceed the recommended dose and take it for a short period of time (1-3 days), it will not have a negative impact on the baby. [1]Interruption of feeding at the time of treatment is not the best option, since the transition to food from a bottle can cause a failure from the breast in the future, because it is easier to get food, and children are still “fitters”.

When should I use paracetamol when breastfeeding? The reason to apply the medicine is the woman’s poor state of health, which prevents her from fulfilling maternal duties, namely:

• high temperature in infectious and inflammatory diseases;
• severe headache and toothache;
• neuralgia;
• muscle pain (myalgia);
• lactostasis - blockage of the milk duct, causing a rise in temperature. [2]

Release form

Due to the particular popularity of the drug and its relative safety, paracetamol is produced in various forms and dosages:

• tablets;
• capsules;
• syrups for children;
• suppository rectal.

A nursing woman can also use baby nurofen. Its active ingredient ibuprofen inhibits the production of prostaglandins responsible for temperature and pain.[3]

Pharmacodynamics

The main characteristics of paracetamol are its antipyretic effect, analgesic, and to a lesser extent anti-inflammatory. This happens due to the suppression of the excitability of the thermoregulation center, biologically active substances responsible for pain receptors, inflammatory mediators.[4]

Pharmacokinetics

The drug is absorbed by the mucous membrane of the upper intestine, through it enters the blood and all cells of the body, concentrating as much as possible 30–40 minutes after administration. It is metabolized in the liver, secreted by the kidneys with a half-period of 1.9-2.5 hours. Antipyretic effect occurs after 2-4 hours.[5], [6]

Dosing and administration

Separate forms and dosages are designed exclusively for children, which indicates the safety of use for children of very young age. For this there are suppositories, syrups. For older children from 6 to 12 years old, able to swallow tablets, you can apply them.[8]

Due to the existence of various dosages, it is best to be guided by their weight or volume in liquid forms. For different age categories, their rules.[9]

Tablets are taken 1-2 hours after a meal with a frequency of 3-4 times a day and washed down with plenty of fluids:

Age (years old)	Single dose	Maximum Daily Dose
3-6	15 mg per kg of body weight	60 mg
6-12	25-50 mg	1-2 g
12 and older	0.5-1.5 g	3-4 g

Rectal suppositories have the same multiplicity of uses:

Age (years old)	Single dose	Maximum Daily Dose
1 month-3 years	15 mg per kg of body weight	60 mg
3-6	25-50 mg	1-2 g
6-12	50 mg	2 g
12 (over 60 kg of weight) and older	75-100 mg	3-4 g

Syrups:

Age	Single dose (ml)	Frequency of admission per day
2-3 months	2.5	2 doses per day
3-6 months	2.5-5	4 times
6-24 months	Five	4 times
2-4 years	7.5	4 times
4-8 years	Ten	4 times
8-10 years	15	4 times
10-12 years	20	4 times
Children weighing over 60kg and adults	20-40	4 times

What dose of medication is safe when breastfeeding? It should not exceed the allowable therapeutic for adults. In addition, you need to try to limit yourself to 2-3 days of treatment, the temperature below 38 ° can not be beaten down. It is best to take paracetamol after feeding the child, until the next its concentration in the body will decrease.

Contraindications

Paracetamol is contraindicated in allergies to the components of the drug, with serious diseases of the liver and kidneys. Suppositories are not used if the rectal mucosa is inflamed.

Side effects Paracetamol for breastfeeding

When used in the treatment of paracetamol, side effects can occur, which consist in reducing myocardial contractility, development of anemia, renal colic, pain in the stomach, nausea, allergic manifestations: rash on the body, itching, swelling. [7]

Overdose

Overdose leads to damage to the liver and it will certainly affect the health of the child. [10]If this happens, you need to stop feeding, and the woman should flush the stomach. For severe symptoms (nausea, vomiting, abdominal pain, dizziness), call an ambulance.[11]

Interactions with other drugs

Anticonvulsants and other anti-inflammatory drugs increase the toxic effect of paracetamol on the liver. Simultaneous long-term treatment with salicylates can cause the development of a malignant process in the kidneys and bladder. Combining it with alcohol provokes exacerbation of pancreatitis. Paracetamol reduces the effectiveness of diuretics. The use of Paracetamol with Ibuprofen reduced the temperature in young children faster than paracetamol alone.[12]

Storage conditions

Paracetamol is stored in the usual conditions for any medication: at a temperature not higher than + 25 ° C in a darkened place (suppositories - + 15 ° C). An opened syrup bottle is usable for 30 days.

Shelf life

Paracetamol is usable for 3 years from the date of manufacture, suppository - 2 years.

Analogs

If it is impossible for any reason to take paracetamol, it can be replaced by analogues, although some of them are not entirely desirable during the period of breastfeeding, which is a warning in the instructions. Only a doctor can evaluate all health risks and make an appointment.

• Viferon - vaginal suppositories, the active ingredient of which is interferon and tocopherol acetate. Treats SARS, influenza, pneumonia, intrauterine and urogenital infections;[13]
• Nurofen  is a nonsteroidal anti-inflammatory drug that is effective in inhibiting the synthesis of prostaglones. Available in tablets and suspensions for children;
• Amoxiclav - antibacterial drug aimed at gram-positive and gram-negative microorganisms; [14]
• Amoxicillin - an antibiotic used for inflammations of the upper respiratory tract, respiratory, biliary tract, urinary system;
• Analgin - an analgesic drug. Reduce or eliminate the pain of a different nature, reduce the temperature during fever;

Analgin (Dipirone) is not approved for sale in the United States by the US Food and Drug Administration or in Canada and in many European countries due to its adverse reactions, including  agranulocytosis. However, it is widely used in other countries during labor and lactation. After the mother takes Analgin and its metabolites appear in breast milk in fairly large quantities. It is found in the blood and urine of breastfed babies, and can cause pharmacological effects in breastfed babies. One case of cyanotic episodes in a breastfed child was associated with taking Analgin breast milk. The drug and metabolites are removed from breast milk 48 hours after ingestion, so it is not recommended to breastfeed the child for 48 hours after the last dose of the drug.[15]

• Arbidol is an antiviral and immunomodulatory agent, effective against influenza A and B viruses, in the complex therapy of bronchitis, pneumonia (contraindicated in lactation!);
• activated charcoal is a completely safe drug, but can only help with stomach pain.

Reviews

Paracetamol - a drug that according to reviews, lactating moms trust. No matter how hard a woman tries to avoid taking medications, during this period she has too many responsibilities, so you have to find ways to alleviate your condition during the illness. A reasonable approach to treatment does not harm the baby.