Preeclampsia, taking aspirin while breastfeeding

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Has anyone been in this situation before?

I'm 12 weeks pregnant with 2nd baby.

Had preeclampsia with 1st, not diagnosed until labour.

Been told to take aspirin (150mg) to try prevent preeclampsia again.

I am still breastfeeding my 2 year old and it's noted in various places including NHS site that there is a (small) risk of Reye's syndrome to breastfeeding child.

I haven't yet started to take the aspirin as with the very little info I have, I do not want to put my child at risk. I am, however, aware of the serious risks of getting preeclampsia again.

Has anyone been in this situation and been given an alternative to aspirin?

Only thing I ask is that there's no "I'd stop breastfeeding" comments. I'm well aware that's the most sensible decision on paper however it's absolutely not right for me or my child.

https://breastfeeding-and-medication.co.uk/fact-sheet/low-dose-aspirin-and-breastfeeding

This is reassuring. I have taken it and continued to bf in a similar situation. Congrats on your pregnancy!

Hi, no alternative that I can suggest but I just wanted to share my experience. I developed HELLP syndrome (a rare form of pre-eclampsia) at 38wks with my first. Was still BFing her when I fell pregnant with my 2nd and I took 75mg of aspirin daily. I did a fair bit of reading about the effect of the aspirin on my daughter but as she was 2.5 I felt comfortable with the relatively minimal dose. Could you perhaps compromise and take a lower dose than the 150mg they've suggested?
As an aside congratulations on the new pregnancy and for breastfeeding for over 2 years already 💖💖

I’ve got antiphospholipid syndrome and the treatment is 150mg aspirin at night. I take it every night, forever, and also all through pregnancy. When I had both my children (2020 and 2023), I was told by my Obstetric consultant, my midwife, the paediatrician (as I was in for a week with both babies) and my haematologist that breastfeeding on aspirin even at my dose carried a risk.

Taking a lower dose of aspirin isn’t a resolution as aspirin still goes to baby via the breast milk. Breast milk is made from blood. Aspirin works by binding to your blood (specifically platelets) and once it binds it stays that way until the platelet dies (so about 10 days), so it’s already in the platelets that go into your milk. At these doses it’s not going to make much difference in terms of how much crosses through your breast milk , and a lower dose is less effective at preventing pre-eclampsia, so just taking a lower dose gives you the worst of both worlds.

My haematologist kept me on lovenox for the duration I was breastfeeding, even though it doesn’t do quite the same thing as aspirin, as I was determined to breastfeed. They weren’t comfortable with me not having any blood thinners at all due to the clotting risk from APS, and also not comfortable with me taking aspirin due to the risk of Reye syndrome risk from the aspirin. Lovenox isn’t an antiplatelet like aspirin, so I was still at risk of a clot from my platelets clumping, but it was seen as better than nothing.

Obviously lovenox isn’t going to help you as it doesn’t help prevent pre eclampsia. I could have continued with my aspirin, but as an informed choice that it carried that risk. Reye Syndrome is very rare, and they don’t know exactly what causes it, but they think aspirin could be one cause. Risks are possibilities, not guarantees that something bad will happen. All I can advise is speak to the professionals and go with the set of risks you can live with. Good luck x

This is hugely helpful, thank you so much! By the looks of it, the aspirin would be somewhat out my system in just a few hours so in theory can be timed after evening feed and would be gone by morning...hopefully I've understood that correctly!!

I think doing 75mg may make me feel happier so think I may go with that actually 🥰

Thanks very much for this. Although it does put me back in the "I'm not taking the aspirin" camp!

Eurgh...why can't things be more simple!!

Great your professionals picked up on the risks and found sort of an alternative for you.

Have managed to arrange a private specialist midwife appointment online tomorrow so hoping they can confirm their thoughts. In some way I just want them to say "don't risk it" so that the decision is made as I guess I'll always question if taking it is the right thing to do 😞

It was very much presented to me as ‘Don’t risk it’.

Even with the aspirin it looked like I was developing PE with the last pregnancy (it’s a risk factor from APS too), luckily I only had to get to 37 weeks - I spent that last week very worried though, and in hospital every day being monitored. Hope you get some well measured advice tomorrow and all goes well x

I started 150mg aspirin the second I got BFP with DC2. I figured it was a low enough dose Reyes was very unlikely, and would be beneficial to the pregnancy. Another factor was that by that point I was only BFing DC1 (then 22mo) to sleep in the evening. So one feed a day made Reyes even less likely.

It wasn't an issue for long though, as both my milk started drying up, and I developed a nursing aversion after a few weeks. Somewhat stopped BF in it's tracks shortly before the start of the second trimester. I was trying to aim for 2yo, but only missed it by a fortnight.

In the end I got pre-eclampsia a second time anyway. It was milder, and I didn't have any high PI readings, so maybe it had a small effect. But not enough of one to matter.

You can call or email the drugs in breastmilk helpline and get a personalised answer (details on the website from the first fact sheet) - I hadn't realised this previously. Listened to a brilliant podcast with the founder of this service when she was interviewed on the midwives cauldron.

Sorry can't offer anything actually directly useful but yes - get in touch with them.

I understand the potential link with Reyes syndrome is if the toddler has a respiratory infection at the same time. Though appreciate at this time of year, that's a lot of the time.

I have taken it as a normal painkiller while breastfeeding just because it was what i had and it was ok.

I didn’t get pre-eclampsia in my second pregnancy. At some stage in my second pregnancy I had to go for a test to see if I was likely to develop it again and the consultant said it was quite clear that I wasn’t. So it isn’t always the case of pre eclampsia developing again with second child.

after the birth of my first child I was advised to take aspirin if I got pregnant again. When I was pregnant the second time I saw a consultant and he said not to. Contradictory info. So I think it’s a good idea that you get a second opinion.