Pain relief post birth while breastfeeding

[elliejjtiny]

Due DC4 in July, hoping to breastfeed.

DC1 - period like after pains, took paracetamol
DC2 - horrendous after pains, took paracetamol and begged midwife for decent drugs but apparantly nothing else is safe while breastfeeding
DC3 - different midwife said I could take ibuprofen and paracetamol. Took both back to back and pain manageable. Milk didn't come in until day 5 and baby lost weight (16%). Paed tutted at me and said it was because of the ibuprofen.
DC4 - another midwife cheerfully told me that afterpains with DC4 are usually similar to labour pains and paracetamol is the only thing you can take [terrified emoticon]

I've done one birth with no pain relief, one with minimal gas and air and one with loads of gas and air (back to back baby) in case I sound really pathetic. Is there any other pain killers I can take while breastfeeding? Surely mums having c-sections get more than paracetamol?

Midwife told me co codamol

You're definitely not pathetic-the afterpains were so painful after DC3. I think paracetamol and ibuprofen is ok. Is there any other medical professional you could check with for a second opinion?

I had nasty after pains with dc3 and took paracetamol and ibuprofen I'm sure. And my milk was fine. Was dc3 your back to back baby? Would exhaustion count against your milk coming in? Mine was very very slow for dc1 after an emcs after induction and I was earth shatteringly shattered. But then again I was also on diclofenac, so can't say which (if any) of these had an effect.

If you'd had a section you could have been offered paracetamol, codeine, ibuprofen, diclofenac and/or morphine.

Telling you all you can gave is paracetamol is bollocks and cruel.

I was given morphine, paracetamol and diclofenac (voltarol) for a few days in hospital and sent home with a supply of voltarol. I don't see any reason not to take ibuprofen - I was told it is fine if breastfeeding.

After my c section, I had paracetamol and cocodamol for about three weeks. And then a few more every now and then over the next few weeks too.

I regularly had codeine post birth and breastfed no problem

I was only given paracetamol after my section because I was breastfeeding. I think it varies quite a lot from place to place

I had horrible surgery after massive haemmorage during labour with DD & was on morphine for a few days then 2 types of painkiller (think one was co-codomal, the other much stronger), anti inflammatories, antibiotics & iron supplements. In total I took 5 pills every 4 hrs for 4 wks & asked several times about breast feeding dangers & was told nothing would hurt the baby. She's now 20 months & fine so presume they were right!

My afterpains were pretty mild after dc1. Despite that, the midwives were practically throwing co-codamol at me, so I'm surprised you've been told that you can't have anything stronger than paracetamol.

I had paracetamol and codeine after my c-section, then switched to tramadol all whilst bf

And the morphine and god knows what else would have been in my system following the surgery

I had co-codamol and diclofenac after my elcs - no question i shouldn't have it, no problems and ds bf'd happily for a year and a half, no formula.

I would check NICE guidelines for pain relief after cs, then get a meeting with a consultant or supervisor of mws to get it written in your notes what you can be given for pain relief if needed.

Otherwise you will be at the whim of whatever mw you get on the day - advice on painkillers seems to vary from place to place and from mw to hv - it is ridiculous and unprofessional to have such substandard care.

Co-codamol worked well for afterpains when DC3 was born and the MW said it was fine to take while bf, milk came in day 4 baby lost no weight at all. I stocked up pre-birth, it's available cheaply over the counter.

I was told no ibuprofen as well. But you can take stronger drugs - I did after forceps with DS and bfeeding.

Worth adding - you can buy the weakest form of co-codamol over the counter, but if you need stronger, you will need a prescription. Do not get fobbed off with mws telling you you can just get co-codamol otc - it comes in quite a few different strengths (diff amounts of codeine).

The co-codamol I had after my cs was not otc strength, it was stronger. And you cannot just take more of the weaker co-codamol, as then you would overdose on paracetamol.

I had DD4 in September. Was dreading the afterpains. Midwife who did my hospital discharge ( was only in a few hours) advised me to stop en- route home and get some paracetamol and ibuprofen and take them together. I took 400mg ibu with paracetamol, and was fine. Didn't affect my milk- infact I had DD at 3.30am on Wednesday, milk started coming in 9pm Friday . If it helps at all, I put DD to the breast very, very frequently in the beginning.

Good luck, hope you have a fantastic pregnancy. I'm loving having 4 DCs.

Just to add my two penneth here, i just had ds2 14 weeks ago, and my midwife advised that one of the benefits of a natural third stage is a reduction in after pains. Having had the injection with my first two babies i decided to try natural third stage and i had no afterpain at all, well nothing besides thats pulling sensation you get when baby latches on. Worth thinking about if its suitable for you medically.

DC2 was my back to back baby. DC3 was my most uncomplicated birth, very calm, only 2 hours labour. All 3 were natural 3rd stage. I'm supposed to be on consultant led care (will probably get an appointment to see one of his/her junior drs soon) so will be asking the dr and any midwife I see until I get the go ahead to take some decent drugs.

What really sparked my annoyance is that I found out that men having vasectomies get more than paracetamol. Nothing like knowing men have a better deal to get me complaining

I'm in Ireland and had tramadol after my CS and my forceps delivery. In both cases my milk came in on day 5. I assumed this was just down to the trauma/pain or maybe my own hormones rather than the meds. I've never read or been told anything about meds delaying lactation.

I had a big episiotomy so needed decent pain relief. I took ibuprofen and paracetamol and was fine. Doc said I could have cocodamol but that it causes constipation so I opted out if that one

I had forceps delivery, with episiotomy & 4th degree tear (which i'm told is similar in pain to a c-section just different area).

I had paracetamol & ibuprofen only, but took it by the clock, not when i was in pain and it was enough. It was my first DC so didnt have to run about after other DC while recovering. I was uncomfortable but not in pain. I took both these religously for about 4-5 weeks and then slowly reduced the amount i was taking over the next 3-4 weeks.

I'm sure i was offered co-codamol but i said i'd start with paracetamol & let them know if i needed something stronger.

I took paracetamol and ibuprofen both times on mws advice and milk came in on day 3 without any problems with supply. A friend of mine who gave birth in the same hospital was told she couldn't take ibuprofen because she was bf there is a lot of conflicting advice! I would also recommend raspberry leaf tea to help your uterus contract back quicker so the afterpains are over sooner.

I recommend cocodamol for after pains. Particularly for the first 48hrs when they are at their worst. Over the counter is usually enough but the heavy duty prescription ones might be needed with the proviso that the more codeine, the more risk of constipation. Cramping from constipation can start them off again!

Another prescription drug that can be used is voltarol (from the same family as ibuprofen) and can be used as a suppository where it acts directly on pelvic pain. Its very effective, used after caesareans or major stitching.

i also recommend hot water bottle on the tum, though some people prefer a cold block wrapped in a tea towel.

Midwife here in NZ gave me a prescription for Voltaren which i believe is diclofenec so they seem to think it's fine not that i've needed it. In UK was offered ibruprofen in hospital for stiches pain and that was only 2 years ago.