Is ibuprofen safe while breastfeeding?

What does the evidence say about ibuprofen while breastfeeding?

1. Extremely low milk levels, a short half-life, and safe use in infants at doses far above what appears in milk make ibuprofen a preferred analgesic and anti-inflammatory choice for nursing parents. 1
2. Ibuprofen is usually the preferred first step for postpartum pain because little of it passes through breastmilk, and acetaminophen is also safe to take while nursing. 2
3. A fully breastfed infant receives on the order of 0.0008 percent of the weight-adjusted maternal dose, and older studies could not detect ibuprofen in milk at all. 1
4. The amount of ibuprofen in breast milk is smaller than the doses given to infants directly, and problems are not expected when it is used as labeled. 3
5. At least 23 published cases describe infants nursed during maternal ibuprofen use with no adverse effects reported, and scheduled ibuprofen plus acetaminophen for 24 hours after vaginal delivery was linked to a higher breastfeeding rate than on-demand dosing, 98 percent versus 88 percent. 1

How ibuprofen changes by nursing stage

• Early weeks. This is when ibuprofen gets used most, for afterpains, perineal soreness, or a cesarean incision. It is also when your provider should be steering the plan, especially if anything else is on board.
• Established nursing. Occasional use for a headache or period cramps sits on the same evidence base. Milk levels stay extremely low across the studies that measured them.
• Weaning. Less milk means even less transfer. The reason to check in with your provider shifts to your own history rather than your baby's exposure.