Breastfeeding and Analgesia

Introduction to Breastfeeding and Analgesia

• The American Society of Anesthesiologists recommends that Endone (oxycodone) should be avoided during breastfeeding when possible, as it poses a greater risk of causing infant sedation than other analgesics and breastfed infants may receive >10% of a therapeutic dose through breast milk 1

Non-Pharmacological Approaches

• Non-pharmacological approaches such as exercise therapy, yoga, tai chi, application of superficial heat, massage therapy, and acupuncture, as well as proper breastfeeding positioning with support, can be used for pain management 2

Pharmacological Options

• The American College of Obstetricians and Gynecologists recommends safer pharmacological options such as paracetamol (acetaminophen) and ibuprofen, which have minimal transfer to breast milk, as well as other NSAIDs (diclofenac, naproxen, ketorolac) which have low levels in breast milk 1, 2
• Morphine is the preferred opioid when stronger analgesia is necessary, due to its safer profile for breastfed infants 1, 2

Oxycodone Use and Precautions

• If oxycodone must be used, it is recommended to limit to single doses intra-operatively, monitor infant for sedation after breastfeeding, avoid doses >30 mg/day, and avoid repeated dosing, due to the risk of infant sedation and respiratory depression 1