Table 5 Summarizing table on treatment of headache in breatsfeeding women
Medication | Adverse effects | Comments |
|---|---|---|
Paracetamol | – | Preferred acute treatment |
Nsaids (Non-selective): Ibuprofen, naproxen, indomethacin | Aggravation of jaundice | Ibuprofen preferred |
Triptans | – | - sumatriptan: no need to ‘pump and dump’ - less evidence on the other triptans: avoid nursing for 24 h after use of triptan as extra safety measurement |
Aspirin (ASA) | Reye’s syndrome | Not recommended |
Caffeine | – | Moderate dosage |
High flow oxygen | – | Preferred acute treatment in CH |
Lidocaine | – | - second line acute treatment in CH - intranasal formulation preferred |
Corticosteroids: prednisone, prednisolone | Prolonged high-dosed therapy: infant growth and development can be affected | Intravenously: delay breastfeeding for 2-8 h |
Weak opioids: tramadol, codeine | Sedation and respiratory depression in the infant | Not considered first line treatment in primary headaches |
Ergots/Ergots Alkaloids | - vomiting, diarrhea, convulsions - decrease of prolactine in the mother | Avoid in any trimester |
Β-blockers: metoprolol, propranolol | - hypotension, bradycardia - weakness | - metoprolol preferred - avoid in children with astma |
ACE-I, ARB | Impact on kidney development | Probably compatible (limited data) |
Verapamil | – | First line CH profylaxis |
TCA | – | No reported AE |
Venlafaxine | – | No reported AE |
Duloxetine | – | No reported AE |
Valproate | Interfere with liver and platelet function | Avoid in women of child-bearing age |
Topiramate | - sedation, irritability - poor suckling, diarrhea | – |
Gabapentin | – | No reported AE |
Lamotrigine | – | No reported AE |
Magnesium, Riboflavine | – | No reported AE |
Flunarizine | – | Not recommended: no data available |
Lithium | Renal toxicity | Not recommended, but can be considered in uncontrolled CH, refractory to Verapamil |
Botox | – | No reported AE when injected correctly |
Nerve blocks | – | No reported AE when injected correctly |