From MMM 2004
"Extremely small amounts secreted into breastmilk.  Few harmful effects have
been reported.  Following single or multiple doses, peak levels occur at
approximately 3 hours and vary from 1.12 to 1.69mg/L.  In another study of
rheumatoid arthritis patient who received 4gm/day, none was detectable in
her milk (<5mg/100cc).  Extremely high doses in mother could potentially
produce slight bleeding in infant.  Because aspirin is implicated in Reye's
Syndrome in febrile-viral illnesses, it is a poor choice of analgesic to use
in breastfeeding mothers.  However, in rheumatic fever patients, it is still
the anti-inflammatory drug of choice and a risk-vs-benefit assessment must
be done in this case.  See ibuprofen or acetaminophen as a better choice.

Pregnancy Risk Category: C during 1st and 2nd trimester
                                       D during 3rd trimester

Lactation Risk Category:  L3

Adult Concerns: GI ulceration, distress, esophagitis, nephropathy,
hepatatoxicity, tinnitus, platelet dysfunction.

Pediatric Concerns: Non reported via milk, but aspirin use in pediatric
patients may increase risk of Reye's syndrome in viral infections.

Drug Interactions: May decrease serum levels of other NSAIDs as well as GI
distress. Aspirin may antagonize effect of probenecid.  Aspirin may increase
methotrexate serum levels, and increase free valproic acid plasma levels and
valproate toxicity.  May increase anticoagulant effect of warfarin.

Theoretic Infant Dose: 0.25mg/kg/day

Relative Infant Dose: 0.04%

Adult Dose: 325-900 mg QID

Alternatives: Ibuprofin, Acetaminophen."

Regards
Suzie Heaton
Australia

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