? newborns and aspirin in breastmilk metabolism

[kohlby]

I've searched on-line and haven't been able to come up with anything. I'm currently on baby aspirin and am supposed to be for life. However, I'm planning on going off it once this baby is born temporarily. I talked to a multitude of medical professionals when I was ttc about the safety of taking a baby aspirin while breastfeeding. And it made me feel comfortable about taking it while nursing a toddler. However, I realize newborns and young babies don't metabolize things the same way as a toddler. For example, I know that caffeine can stay in a newborn's system for up to 80 hours.

Does anyone know how long aspirin can stay in their system? And at what age does it get processed better? A baby aspirin through breastmilk is a very low amount, especially since I only take one a day. But I'm worried about the effects of it building up in their stystem. Right now, I'm thinking of starting back up when baby is 6 weeks old, since I'll be going off heparin 6 weeks post-partum. (Currently, while pg, I'm on both heparin and baby aspirin. Ideally, the dr would want me on both in the post-partum period but I'm not comfortable with that, at least initially).

[Rieckah]

http://neonatal.ama.ttuhsc.edu/cgi-bin/discus/discus.cgi?pg=topics&access=guest

You can look here for any medication

[kohlby]

Thanks! It didn't tell me anything about how its metabolized though, I guess it's just not known. Hale said:
Honestly, we don't know if there is any risk for the infant from low-dose aspirin. I don't believe it is a major risk factor, but I must tell you we don't really know for sure.

I'm planning on skipping the vitamin K shot so even if there is no problem with the aspirin then I'll wait 2 weeks.

[KerryS]

The concern about aspirin in breastfed babies is less about the anticoagulatory properties, and more about its association with Reye Syndrome.

[kohlby]

Kerry - The only anticoagulatory issue I'd be concerned about would be when the baby didn't have the vitamin K built up yet since I'll likely skip the shot- which I'm thinking happens by day 8 if I remember correctly. But Reye's Syndrome is a concern to me the entire time if aspirin is a problem. I just wish I knew more about how newborns metabolize asprin.

[KerryS]

Why can't you just take Lovenox?

[kohlby]

I am taking heparin - but I take baby aspirin and heparin together right now. I'll continue the heparin for 6 weeks after the birth and then I can go off it. The daily baby aspirin is a just in case thing for the rest of my life. I'm not high enough risk to need to go on coumadin since I've never had a clot. (Actually, my peri does coumadin after the birth instead of heparin but I am more comfortable with staying on the heparin). There is the risk of bone loss while on heparin and the shots aren't exactly pleasant so I'm looking forward to the end of it at some point! I've read the risk of bone loss is small with lovenox but still there and the shots don't hurt as much. But since I've never had a blood clot, I'm comfortable with going off of the heparin once the risk period is over for me post c-section.

[AuLait]

I'm taking a baby aspirin daily for migraine prevention. I quit while pregnant and just started up again now that baby is 6 months old. Like you, I had trouble finding what, if any, impact it had on pregnancy and breastfeeding, so I quit all together until now. I really only restarted because my headaches were getting more frequent and painful. I would have waited until closer to a year otherwise.

Its hard to make these decisions when there isn't a lot of information about side effects and impacts on infants and young children.

[Amy_G_]

ok, this is the info in dr. hale's book, and my description of what yhey mean.

it's an L3, which doesn't overly concern me by itself.

the half life of aspirin is 2.5-7 hours. so in less than 7 hours half of your dose is in your system, and in less than 14 hours, half of half of your dose is in your system.

It peaks in your system in 1-2 hours. So it doesn't enter your system immediately, so take it, breastfeed, and try to wait > 2 hours before breastfeeding again to avoid the peak amount in your system. although in the table it says 1-2 hours for peak, and in the description it says 3 hours til peak. so your mileage may vary.

it is 80-100% bioavailable, which means most of what you take is absorbed by your system, and which means most of what enters breastmilk is absorbed by baby's system as well.

molecular weight is 180, which is low, which means it passes thru the blood/breast barrier pretty easily.

volume of distribution is .015. volume of distribution describes how widely the medication is distributed in the body. Drugs with high volumes of distribution (1-20 liter/kg) are distributed in higher concentrations in remote comparments of the body, and may not stay in the blood. Drugs with high volumes of distribution generally require much longer to clear from the body than drugs with smaller volumes because the medicine is stores elsewhere in the body.

pB is the % of protein binding. If a drug is highly protein bound it cannot exist the plasma compartment. higher % is less likely to enter maternal milk. good protein binding is >90. apirin is 88-93%

adult doseage is listed as 325-900 mg 4 x daily.
Theoretic infant dose is .3 mg/kg/day.

please ignore spelling errors, I was copying a lot of this from my dr hale's book. It is 2002 edition, I doubt there is any new info on aspirin, but maybe someone with a newer eddition can check.