Can You Take Ibuprofen While Breastfeeding? Ibuprofen, Tylenol and What to Avoid

Headaches, after-birth cramps, a sore C-section scar, a painful tooth: there are plenty of reasons to reach for a pain reliever in the months after birth. If you’re breastfeeding, the two most common options are also the two best studied.

Here is what the evidence says about ibuprofen and acetaminophen, why aspirin is usually skipped, and where naproxen fits in. For the general principles behind how medicines reach milk, see our hub on what’s safe while breastfeeding.

Ibuprofen while breastfeeding: the short version

Ibuprofen (Advil, Motrin, and many store brands) is one of the most reassuring medicines you can take while breastfeeding. LactMed, the National Library of Medicine’s lactation database, calls it a preferred choice for pain or inflammation in nursing mothers because:

• levels in breast milk are extremely low,
• it has a short half-life, so it leaves your body quickly, and
• babies are safely given ibuprofen directly at doses far higher than anything they could get through milk.

MotherToBaby adds that when it is used as directed, side effects are not expected in babies exposed through breast milk. There is no need to pump and dump or to time feeds around a dose.

Use the standard adult dose on the label for the shortest time you need it.

When ibuprofen may not suit you

The medicine is fine for the baby, but it isn’t right for every mother. The Breastfeeding Network notes you should check with a doctor or pharmacist first if you have asthma or a history of stomach ulcers. The Drug Facts label on ibuprofen packs also asks you to talk to a doctor first if you have had stomach bleeding, or have high blood pressure, heart disease or kidney disease, or take a diuretic or blood thinner.

Acetaminophen (Tylenol) while breastfeeding

Acetaminophen, called paracetamol outside the US, is the other first-line option. LactMed describes it as a good choice for pain relief and fever in nursing mothers. The amounts in milk are much lower than the doses usually given to infants, and side effects in breastfed babies appear to be rare.

Acetaminophen is a good pick when you have a fever, or when ibuprofen doesn’t suit you. It does not reduce inflammation the way ibuprofen does, so for swelling or inflamed tissue, ibuprofen may work better.

One thing to watch: acetaminophen hides in many combination products, including DayQuil, NyQuil and most “cold & flu” or “PM” products. Add up all sources so you stay within the daily maximum on the label. Our guide to cold medicine while breastfeeding explains how to read those labels.

Can you take ibuprofen and Tylenol together?

The Breastfeeding Network says paracetamol (acetaminophen) and ibuprofen can be taken together while breastfeeding if needed, as long as you stay within each medicine’s maximum daily dose. LactMed also notes that giving both on a fixed schedule for 24 hours after a vaginal birth appears to increase breastfeeding rates, likely because mothers are more comfortable.

Because combining or alternating doses is easy to get wrong when you’re tired, ask your doctor or pharmacist to write down a plan for you.

Comparing common pain relievers

Medicine	Brand examples	Breastfeeding summary
Ibuprofen	Advil, Motrin	Preferred choice; extremely low milk levels
Acetaminophen	Tylenol	Good choice for pain and fever; rare effects in babies
Naproxen	Aleve	Low milk levels; other options may be preferred with a newborn or premature baby
Aspirin (pain-relief doses)	Bayer, Excedrin (combined)	Not usually recommended as a painkiller; ask a doctor first
Low-dose aspirin (prescribed)	“Baby aspirin”	Different situation; check with your doctor, and watch your baby for bruising or bleeding

Why aspirin is usually avoided

Aspirin passes into breast milk. The NHS says taking a higher dose of aspirin for pain is not usually recommended while breastfeeding because there’s a risk it could cause side effects in your baby, and that paracetamol is usually the best painkiller to take. The Breastfeeding Network points to a possible link between aspirin and Reye’s syndrome in children, a rare but serious condition, and says the risk is very low but that other pain relief options are available.

LactMed says higher aspirin doses lead to disproportionately higher levels in milk, that the risk of Reye’s syndrome from salicylate in breast milk is unknown, and that an alternate drug is preferred over continuous high-dose aspirin.

Two important exceptions:

• Low-dose aspirin prescribed for heart or clotting reasons is a different situation. LactMed says that with low-dose aspirin (75 to 325 mg daily) salicylate levels in milk are low, and that if a nursing mother uses aspirin, her baby should be monitored for bruising and bleeding. The NHS says to check with your doctor before taking low-dose aspirin while breastfeeding. Don’t stop a prescribed medicine without talking to your doctor.
• If you took a single aspirin by mistake, the Breastfeeding Network says you can keep breastfeeding because the risk is very small. Just switch to another pain reliever for later doses.

What about naproxen (Aleve)?

Naproxen is an NSAID like ibuprofen, but it stays in the body much longer. LactMed says that because of its long half-life and one reported serious reaction in a breastfed newborn, other medicines may be preferred while you’re nursing a newborn or premature baby. It also says milk levels are low and adverse effects in breastfed infants are apparently uncommon.

In practice, ibuprofen is usually the simpler first choice. If naproxen is what works best for you, for example for period pain once your cycle returns, check with your doctor or pharmacist, especially in the early weeks.

Pain relief for common breastfeeding problems

Ibuprofen is part of the standard advice for several breastfeeding problems, because it eases both pain and inflammation:

• Engorgement: cold packs between feeds plus ibuprofen can reduce swelling. See our guide to engorged breasts.
• Mastitis and inflamed ducts: current guidance recommends ice and NSAIDs such as ibuprofen, rather than deep massage. Read more in our mastitis guide.
• Sore nipples: a pain reliever can help you get through feeds while you fix the cause, which is usually the latch.

When to call a doctor or lactation consultant

Pain relievers treat symptoms, not causes. Contact your doctor if:

• you need pain medicine for more than a few days in a row,
• you have a fever, a red, hot or hard area on your breast, or flu-like aches,
• you have a severe headache, especially with vision changes or high blood pressure in the weeks after birth (this needs urgent care), or
• you have pain from a C-section or tear that is getting worse rather than better.

If breastfeeding itself is painful, an IBCLC can check latch and positioning. Our breastfeeding support page explains how to find one.