Last update Feb. 5, 2022
Very Low Risk
Breastfeeding does not make migraine worse, and most migraine treatments are safe while breastfeeding, so migraine almost never forces you to stop breastfeeding. (Burch 2020 and 2019, Bordini 2016, Wells 2016, Amundsen 2015, Davanzo 2014 , Beseler 2008, Loder 2007)
Breastfeeding can prevent migraine recurrence postpartum: 100% of mothers who do not breastfeed have a recurrence in the first month, compared to only 43% of those who do breastfeed. (Sances 2003)
For treatment, ibuprofen or paracetamol are compatible alone or in combination with low doses of codeine or caffeine. Diclofenac, ketorolac, and naproxen are also compatible; metoclopramide, domperidone, dimenhydrinate, and prochlorperazine are considered safe in breastfeeding. (Anderson 2019, Worthington 2013, Hutchinson 2013, Pringsheim 2012, MacGregor 2007, Silberstein 1993)
Among the triptans, sumatriptan and eletriptan are the safest. (Burch 2020, Anderson 2019, Davanzo 2014, Worthington 2013, Hutchinson 2013, Duong 2012, Jürgens 2009, Raña 2008, MacGregor 2007)
It is necessary to avoid preparations that are combinations of drugs and derivatives of phenazone or ergot, barbiturates and sedatives.
As prophylaxis, propranol, atenolol, metoprolol, magnesium, various antiepileptics (gabapentin, valproate, topiramate, levetiracetam) and antidepressants such as verapamil or amitriptyline, escitalopram, paroxetine or sertraline are compatible.(Burch 2020, Anderson 2019, Davanzo 2014, MacGregorgens 2009).
OnabotulinumtoxinA is not detectable in maternal plasma after intramuscular use; therefore, its excretion in human milk is unlikely. (Anderson 2019).
Monoclonal antibodies such as erenumab, fremanezumab, and galcanezumab have very high molecular weights that prevent their excretion in human milk and cannot be absorbed from the infant's gut (Anderson 2019). A 22-month-old infant whose mother was taking eremumab did not experience any developmental or infectious side effects. (Henze 2019)
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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Thank you for helping to protect and promote breastfeeding.
e-lactancia is a resource recommended by Asociación Española de Bancos de Leche Humana of Spain
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM