Headaches occurring during lactation, where there is no other apparent physiological cause, can usually be categorized under three general headings: those related to hormonal changes or other lactation-related triggers (deemed to be true lactational headaches); those no different from headaches experienced by the general population and not influenced by lactation; those triggered by a combination of factors (Thorley 2000).
Thorley (2000) identifies two main types of lactational headaches. Type 1 appears to be linked to the surge of oxytocin at let down. Some women experience this headache during the feed rather than at the beginning, and this may be linked to let downs which occur throughout the feed. Type 2 headaches are different in that the let down brings relief, the pain appearing to be caused by overfull breasts. This type of headache may, however, be the precursor of mastitis.
Diary keeping may be helpful in identifying and avoiding triggering factors for lactational headaches. Such information as the date, time and duration of the headache, and any other identifying factors, could be helpful (Thorley 2000).
Non-pharmacological treatments such as physiotherapy and breathing and relaxation exercises may be recommended. Some mothers have successfully used techniques such as chiropractic and lymphatic drainage, though these treatments have not been assessed (Thorley 2000).
Over-the-counter medications, such as ibuprofen, paracetamol and panadeine may be used to treat these headaches. Where stronger medications are required the effects on the breastfed baby need to be taken into consideration. In some, very rare cases, these headaches are so debilitating that the medication necessary for pain relief is not suitable while breastfeeding (Askmark & Lundberg 1989).
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