Author: Joanne Lewsley
Migraine affects millions of people in the United States. Although the condition can sometimes improve during pregnancy, it may worsen in the postpartum period and sometimes while breastfeeding.
According to the American Migraine Foundation, migraine is a debilitating condition that affects around 39 million people in the U.S. Chronic migraine, when a person has more than 15 days of migraine each month, affects up to 1 in 20 people.
A migraine can be moderate or severe. A person with migraine may experience:
- throbbing or pounding pain on one or both sides of the head
- head pain that gets worse with physical activity or movement
- nausea or vomiting
- sensitivity to light and sound
In this article, we examine the link between migraine headaches and breastfeeding. We also look at migraine medications that are safe to take while breastfeeding and migraine prevention tips.
There is not enough clear evidence to say whether breastfeeding can improve or worsen migraine headaches.
According to a 2013 article in Headache: The Journal of Head and Face Pain some data suggest migraine may improve during breastfeeding. Still, more than 50% of people experience migraine recurrence with 1 month of delivery.
Primary headaches, which include migraine headaches, tension headaches, and cluster headaches, are common in pregnancy and postpartum.
While migraine may improve during the second and third trimesters of pregnancy, many people often experience the onset of migraine episodes in the first days and weeks after birth.
Among females who have experienced past migraine headaches, the American Migraine Foundation says that:
- 1 in 4 will experience migraine within the first 2 weeks after birth
- almost 50% will experience a migraine episode in the first month
Additionally, 5% of females who have never experienced migraine may have their first migraine postpartum. This may be because of fluctuating hormones in the days after birth.
While the American Migraine Foundation does not mention breastfeeding as a factor in the onset or worsening of migraine, it does note many contributing factors to migraine that new parents will likely recognize, such as:
- tiredness and fatigue
- broken sleep
- missing meals
- being dehydrated
Breastfeeding can be exhausting in the early days and weeks, and night feeds can cause disrupted sleep. Many people may forget to nourish and hydrate themselves while feeding their infants. All these environmental factors around breastfeeding could contribute to migraine headaches.
Several medications are safe to take for migraine headaches while breastfeeding. These include:
- acetaminophen (Tylenol)
- nonsteroidal anti-inflammatories, such as ibuprofen (Advil), diclofenac, or naproxen (Aleve)
- sumatriptan (Imitrex)
There is conflicting messaging on whether other medications, such as antidepressants, beta-blockers, and anticonvulsant medications, are safe to use during breastfeeding. A doctor can provide advice on the risks and benefits of these medications while breastfeeding.
Factors that a healthcare professional will take into consideration when prescribing medications may include:
- the benefits to the infant and person breastfeeding
- the risks of drug exposure to the baby or breast milk production
- when a person should take the medication and how long they should take it
People who want to take prescription medication not currently approved for pregnancy or breastfeeding should speak to a healthcare professional about available options.
Medications that are not safe to take while breastfeeding may include:
People should consult a doctor before taking aspirin for migraine headaches while breastfeeding. It may be reasonable for people with certain conditions to take aspirin at low doses while monitoring the baby for any adverse effects. However, aspirin can cause salicylic acid to develop in breastmilk. This is dangerous for a baby and may lead to metabolic acidosis with life threatening consequences.
People should not take opiates, such as codeine and tramadol, for migraine pain while breastfeeding. The Food and Drug Administration (FDA) warns that opiate use during breastfeeding results in excessive sleepiness and severe breathing problems in infants
Other causes of postpartum headaches may include:
Headaches can be common in the postpartum period and may sometimes happen as a direct result of factors during delivery. For example, epidural or spinal procedures for pain relief may cause headaches hours or days after birth in some circumstances.
Postpartum preeclampsia can also cause a headache in the first few weeks after birth. A person should seek emergency medical help as soon as possible if they experience symptoms such as:
- a new or unusual headache
- vision changes or problems
- swollen face, arms, and legs
- stomach pain
- nausea and vomiting
- decreased urination
- sudden weight gain
The early days and weeks after delivery can be stressful. Lack of sleep, difficulty maintaining adequate nutrition and hydration, and anxiety about their newborn may cause people to develop tension headaches. Trying to maintain a healthy lifestyle and sleeping pattern may help ease symptoms over time.
The following self-help tips may help prevent or slow down the frequency of migraine headaches:
- keeping a headache diary to identify triggers such as disrupted sleep, stress, dehydration, or missed meals
- taking any medications a doctor prescribes on time every day
- cutting down on caffeine
- trying to exercise regularly and keep to a moderate weight
- using relaxation techniques to unwind
A person considering herbal remedies to treat their migraine headaches should speak to a healthcare professional first. Aside from there being little evidence that herbal remedies can help with migraine headaches, some may be harmful to a baby if they pass into breastmilk.
A person should speak with a healthcare professional if they experience:
- a new headache after giving birth
- worsening migraine symptoms
- severe migraine symptoms
A person should seek emergency help if they experience:
- an unusually severe headache
- difficulty speaking
- vision problems
- uncontrollable vomiting
- paralysis or weakness in the arms or the face
- a headache with fever, stiff neck, confusion, seizures, vision problems, or a rash
Although migraine headaches can worsen postpartum, there is little evidence to suggest that breastfeeding is the cause. However, factors associated with breastfeeding, including disrupted sleep and poor hydration, may be contributing factors.
Breastfeeding parents may wish to use over-the-counter medications to treat migraine symptoms or speak with a healthcare professional about prescription medications that are safe to take while breastfeeding.