Last update: July 31, 2018
Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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A non-steroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory and antipyretic properties.
Usually administered orally, every 4-6 hours to reduce pain or fever and every 24 hours and at low dose (100 mg/day) as an platelet antiaggregant.
The consumption of aspirin has been quite reliably related to the appearance of Reye syndrome, especially in early childhood (Schrör 2007, Waldman 1982), so in many countries its use is discouraged in children under 12-16 years of age (Unsworth 1987).
It is excreted in small amounts in breastmilk (Datta 2017, Athavale 2013, Bailey 1982, Findlay 1981, Erickson 1979), becoming insignificant when the maternal doses of aspirin are less than 500 mg (Datta 2017).
Although low plasma levels have been detected in infants (Unsworth 1987), there have been no reports of Reye syndrome due to aspirin in breastmilk and it is considered very unlikely that it could occur with isolated doses or at low doses used in antithrombotic treatments and for anti-abortion purposes.
Various medical associations and expert consensus consider safe or probably safe its occasional isolated use or in antiaggregant dose during breastfeeding (Datta 2017, Noviani 2016, Rowe 2013, Sachs 2013, Bates 2012, Bell 2011, Chen 2010, Bar-Oz 2003, WHO 2002, Spigset 2000).
With maternal doses in the usual analgesic - antipyretic - anti-inflammatory therapeutic range there are three old publications on side effects in the infant: a very doubtful case of salicylic poisoning in the neonatal period (Clark 1981), thrombocytopenia in an infant (Terragna 1967) and a hemolytic crisis in a 23-day-old infant affected by glucose-6-phosphate dehydrogenase deficiency (Harley 1962).
Other studies have not found any problem in infants whose mothers were taking aspirin (Ito 1993).
For use at usual doses as an anti-inflammatory, analgesic or antipyretic, safer known alternatives are preferred during breastfeeding (Noviani 2016, Davanzo 2014, Bloor 2013, Sachs 2013, Worthington 2013, Risser 2009, WHO 2002, Janssen 2000).
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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