The half-life of paracetamol in both mother's plasma and milk is 2.6 hours. After a dose of 650 mg, maximum concentrations of 15mg/l were measured in the milk. Thus, an infant can get as much as 0.45 mg/kg at a feed. This is about 4% of the weight-related individual therapeutic dose in infancy. The M/P ratio is 1. Beyond one report of a reproducible maculopapular exanthema after 1 g of paracetamol, no undesirable effects have been reported following breastfeeding (survey in Bar-Oz 2003, Bennett 1996). No side effects were observed among 43 breastfed infants of mothers treated with paracetamol (Ito 1993). Since metabolism and renal excretion are not fully developed in the newborn, accumulation cannot be ruled out in the case of long-term treatment (Notarianni 1987).
Recommendation. Apart from Ibuprofen, paracetamol belongs to the group of analgesics of choice during breastfeeding.
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For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.