Is there something I can take while bf?

[Miss.September]

I've destroyed my back. I have an old injury that flares when I've overdone it and yep, I've overdone it (surprise surprise).

My usual savior is Voltaren gel, works like a treat. But it says no when bf. DD2 is fed probably 2-3 times during the day, 4-6 times overnight (she's just turned 1).

I've taken Voltaren tablets but is there anything safe that you have used to rub on? I'm not really mobile and I have DD1, DD2 (who isn't walking and needs lifting) and a sick dog to take care of!!!!!

[HotI]

From LACTMED

Drug Levels and Effects:


Summary of Use during Lactation:
Data on excretion of diclofenac into milk are poor, but the drug has a short half-life and little glucuronide metabolite formation. Most reviewers consider diclofenac to be acceptable during breastfeeding.[1][2][3][4] Other agents having more published information may be preferred, especially while nursing a newborn or preterm infant.


Drug Levels:
No original data on the excretion of diclofenac into milk are available. Data are limited to those reported in review articles in which no study details are reported.

Diclofenac was undetectable (<100 mcg/L) in the breastmilk over a 6-hour period after a 50 mg intramuscular injection in 6 women.[5][6]

Six mothers were given oral diclofenac 100 mg daily orally for one week postpartum. The drug was undetectable(<10 mcg/L) in milk of any of 59 samples of milk collected (collection times unspecified).[6]

A woman treated with 150 mg daily of diclofenac had a breastmilk diclofenac level of 100 mcg/L, equivalent to about 0.03 mg/kg daily for the infant.[7]


Effects in Breastfed Infants:
In one study, 30 mothers undergoing elective cesarean section were allowed to use 25 mg diclofenac suppositories along with either spinal or spinal and epidural anesthesia with a local anesthetic after delivery. The spinal anesthetic group used an average of 56 mg of diclofenac on the day of delivery and 33 mg on the next day whereas the women receiving both spinal and epidural anesthesia used 21 and 18 mg. No mention was made of adverse effects on the breastfed infants.[8]

An breastfed infant developed urticaria on day 15 of life. Her mother had been taking diclofenac (dosage unspecified) for pain since her cesarean section delivery. Diclofenac is a possible cause of the urticaria; however, the infant had also received hepatitis B vaccination 7 days before and the authors thought that it was a more likely cause of the reaction.[9]


Possible Effects on Lactation:
Relevant published information was not found as of the revision date.


Alternate Drugs to Consider:

MG uses one from her physio that i think is called physicream - ok for pregnancy and breastfeeding.

I would have thought that if oral meds are ok, skin meds would be ok. Voltaren is often given straight after birth in breastfeeding Mums, so with an older bub it is going to have less effect (more body weight/better metabolism). You can give Rodney Whyte a call if you want to check.

[Miss.September]

Thanks HotI. They gave me the pills in hospital after I had DD2. Reading that, I think I'll risk the gel. I've got to be able to move!

[HotI]

I didn't use voltaren while pregnant, but have used both pills and gel while breastfeeding. i just wash my hands after applying so the child is not getting direct gel.

[~clover~]

I used the gel while BFing, but DD was a bit older.
Voltaren tablets are my saviour though. Some days I can't walk without them. Nurofen has nothing on voltaren!

[Miss.September]

Thank you. Used the gel, now we wait.

[onthefly]

Topical treatments should really be fine. Hope you're feeling better soon