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Q
Medicate Migraines While Breastfeeding?

I am a breastfeeding mom who suffers from migraines. Are there supplements that can prevent migraines but are still safe to use when breastfeeding? What about treatments when I have a migraine - are any of them safe to use?

A
Answer (Published 8/1/2005)

Fortunately for about 70 percent of women who suffer from migraines, pregnancy improves matters, at least temporarily. If you're very lucky, the migraines might not return now that your baby is born. But if they do, dealing with them can be tricky, especially if you're breastfeeding. You don't want your baby ingesting potentially harmful drugs that might be excreted in your breast milk.

You can safely take several supplements to prevent migraines while you're breastfeeding. Not all of them work for everyone, but they're certainly safe and worth a try. Vitamin B2 (riboflavin) can be helpful, as can magnesium and the herb feverfew, which is available at health food stores. The recommended dose of riboflavin is 400 mg daily - a pretty high dose, which needs to be prescribed by a physician. Recommended dosage for magnesium is anywhere between 400-600 mg daily, sometimes higher. Dosage of feverfew is 100-250 mg of an extract standardized to .7 percent parthenolides.

Another herb, butterbur, which recently has proved to be as effective and safe as some prescription drugs for migraine prevention isn't recommended for women who are pregnant or breastfeeding because the appropriate safety studies haven't been done. In addition to supplements, you might also consider biofeedback as a non-drug approach to reducing the frequency and intensity of your migraines. Certain medications used to prevent migraines are safe to use while breastfeeding. They include some of the beta blockers (drugs used to treat high blood pressure that can also effectively prevent migraines).

While you have to be careful about medications used to treat headaches that do develop, some are safe for use by nursing mothers. You can get a complete list of which ones are safe to take and which ones should be avoided at the Web site of the American Council for Headache Education (ACHE). ACHE is the patient education arm of the American Headache Society, a professional organization of health professionals who specialize in headache treatment. You'll see that some widely used medications for pain are okay to use while nursing. Unfortunately, the "triptans," drugs especially designed for migraine treatment, must be used with caution since the medication can be excreted in breast milk. If you have a prescription for one of these drugs, I suggest that you consult your physician before using them while nursing.

Andrew Weil, M.D.

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