Ilene:  Just my aditional .02 worth.  As Dr. Newman's recent post so
eloquently stated, whenever a drug whose safety in breastfeeding is not
known, there is usually an alternative which is "tried and true".  Why is
ultram (tramadol) the only med which will work for this mother's pain?
Is she unable to tolerate the NSAID's  (non-steroidal
anti-inflammatories) such as ibuprofen, naproxen, etc which are known
compatible with breastfeeding?  What about acetaminophen, either alone or
in combination with codeine?
Needless to say, but sometimes forgotten, there are many
non-pharmaceutical treatments for back pain which are very effective,
including but not limited to moist heat, massage, physical therapy,
chiropractic, back exercises, TENS (trans-electric nerve stimulator),
etc, which may be helpful.  Alicia.  [log in to unmask]