Toradol? Do you give it to breastfeeding moms?

OhioMTCRN07 · Apr 28, 2010

To moms with a C-section yes, we give 2 doses IV push every ?6 hours 30 mg if I recall correctly then switch over to oral ibuprofen 600 mg every 6 hours prn; moms with lady partsl delivery receive ibuprofen (prn basis) every 6 hours.

allnurses Guide · Apr 28, 2010

jennifers said:
Does your hospital give toradol to breastfeeding mothers I've read conflicting information about this and was wondering what other hospitals do.

I give/order toradol all the time regardless of breastfeeding status.

Here is some information I found:

Breast Feeding Summary

Ketorolac is excreted into breast milk (11). Ten women, 2 to 6 days postpartum, were given oral ketorolac, 10 mg 4 times daily for 2 days. Their infants were not allowed to breast-feed during the study. Four of the women had milk concentrations of the drug below the detection limit of the assay

classicdame, MSN, EdD · Apr 28, 2010

My PDR states it is contraindicated in breastfeeding moms due to reports of adverse effects in the neonate.

Elvish, BSN, DNP, RN, NP · Apr 28, 2010

We give it all the time to our BFing c/section mamas. Q6h x 24hrs. Never had a problem.

A lot of package inserts or drug information put out by the manufacturer will say a product is 'contraindicated' or some such thing while breastfeeding. That's to cover their butts in the (extremely rare) case of a reaction. Very few meds are actually contraindicated, though. Our resource book is Medications and Mother's Milk by Dr. Thomas Hale - he even says you can breastfeed after getting Radiopaque contrast dye (we always heard you had to pump & dump x 24-48hrs). Getting back to the point - no, we give a lot of Toradol and have never had issues.

classicdame, MSN, EdD · Apr 28, 2010

If I know a medication has this warning I would want documented proof that it is ok to give. Otherwise, it is a med error and my judgement would be questioned. Got to have more than empirical evidence (we always did it that way).

Elvish, BSN, DNP, RN, NP · Apr 28, 2010

Aforementioned book - Medications and Mothers' Milk - says it is considered safe, and wtbcrna's post above breaks it down quite nicely as well. (Matter of fact, I think it sounds like it comes right out of M&MM. They have their own category for rating medications, but they give recommendations from ACOG and the AAP as well.)

CEG · Apr 28, 2010

classicdame said:
My PDR states it is contraindicated in breastfeeding moms due to reports of adverse effects in the neonate.

PDR is not an accurate source for breastfeeding info. PDR info comes from the manufacturer. Breastfeeding info should come from another source- LACTMED or Hale are considered best.

jennifers · Apr 28, 2010

All the dr's order it yet on the emar from pharmacy it says Unless breastfeeding. So, you can see my hesitation to give that and say lanolin at the same time. I'm not as concerned about the passing through the milk supply as if it would effect the supply itself.

jennifers · Apr 28, 2010

also should we really be giving moms ibuprofen when our number one concern is bleeding? Am I over thinking these things?

klone, MSN, RN · Apr 28, 2010

Yes, Hale's "Medications and Mothers Milk" should be considered the gold standard by which to determine if a med is safe with breastfeeding.

Elvish, BSN, DNP, RN, NP · Apr 29, 2010

jennifers said:
also should we really be giving moms ibuprofen when our number one concern is bleeding? Am I over thinking these things?

We have been known to hold Toradol/Motrin if Mom has a known clotting disorder or hx GI bleeds, but for the general population, no, it's not been a huge concern.