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Essentially all common painkillers are safe in the first three to four days after delivery, which is when these painkillers are most often used – as long they're taken as prescribed. That's because in those first few days, a breastfeeding mother produces and feeds her newborn relatively little milk.
After that, many painkillers continue to be safe when taken as directed. Narcotics such as codeine are destroyed by your baby's stomach acid and are poorly absorbed out of your baby's intestine. And most non-narcotic pain relievers, such as ibuprofen or acetaminophen, are safe unless they're taken in high doses. Your doctor can tell you how much is safe.
If you're taking a narcotic painkiller and you notice any unusual changes in your infant – such as excessive fussiness or sleepiness – be sure to tell your pediatrician, though it's unlikely it's being caused by your medication.
Learn more about the safety of commonly used medications during breastfeeding.