Headache during pregnancy and breastfeeding

Sign up

Price

Our doctors

Headaches during pregnancy occur quite often, and, as a rule, they are not dangerous to health.

Noise, stress, fatigue, too little outdoor exercise, lack of sleep, as well as too much sleep (especially in the second half of pregnancy), insufficient fluid intake and poor nutrition are the main culprits of headaches during pregnancy. Pain that occurs in early pregnancy can be associated with hormonal changes. An increase in the synthesis of estrogen and progesterone, necessary for the development of a child, causes water retention in the tissues. Swelling occurs, including in the brain tissue, where nerve receptors respond with pain to increased pressure. Fortunately, this is not dangerous for the mother and fetus.

TREATMENT OF HEADACHES DURING PREGNANCY AND BREASTFEEDING IS AVAILABLE AT: BRANCHES

Treatment of headaches during pregnancy and breastfeeding in the Primorsky region

Address: St. Petersburg , Primorsky district, st. Repisheva, 13

Treatment of headaches during pregnancy and breastfeeding in the Petrograd region

Address: St. Petersburg , Petrogradsky district, st. Lenina, 5

Treatment of headaches during pregnancy and breastfeeding in Vsevolozhsk

Address: Vsevolozhsk , Oktyabrsky Prospekt, 96 A

Diagnostic methods

Comprehensive diagnosis is an important stage for prescribing competent treatment. It is important to determine what caused the headaches in order to select effective and safe medications. The doctor may prescribe the following stages of examination:

• general and biochemical blood tests;
• determination of hormone levels in the blood;
• diagnostics of the condition of the heart and blood vessels (pressure measurement, electrocardiography, Dopplerography of the vessels of the neck and head);
• radiography of the thoracic and cervical spine;
• MRI, CT as necessary.

At the Clinical Brain Institute, you can undergo a full examination to determine the cause of headaches during breastfeeding. In our center, diagnostics are carried out using modern equipment, which allows us to obtain the most accurate results.

Prevention of headaches during pregnancy

First of all, you need to relax. In fact, there are more important things than the mood of the boss, the color of the wallpaper in the room or the order in the closet. Every day you should provide yourself with 8-10 hours of sleep. It is necessary to remember about walks and regular meals, because hunger is manifested not only by sensations in the stomach, but also by headaches. Your diet should contain sources of magnesium (buckwheat, flour, pumpkin seeds, cocoa, bananas), since a deficiency of this element often causes tension headaches. Such dull and not very severe pain can persist for a week.

Even slight dehydration can cause similar problems, so don't forget to drink. It is worth remembering that not all drinks are equally good during pregnancy. Coffee, tea, or thick juices may cause the body to lose fluid or interfere with its absorption. The best option is pure non-carbonated water with a low content of minerals (up to 500 mg of elements per liter), which will not put too much strain on the kidneys, which bear a double load during pregnancy.

It is necessary to remember about a comfortable bed, because the spine can also be the cause of headaches. The mattress should not be too hard, since on a hard base your bones and muscles are constantly under tension and do not rest, and not too soft, since in this case the load on the spine will be uneven.

Post-puncture headache (PDPH)

The widespread introduction of spinal anesthesia into the practice of obstetric anesthesiology leads to a significant improvement in the outcomes of cesarean section, which is good news. But along with this, obstetric anesthesiologists are faced with PDPH. According to the available literature, PDPH appears within 1-3 days after puncture of the dura mater during spinal anesthesia in 2-3% of cases in general surgical practice and in 5-6% when performing SMA during a cesarean section and or almost always after an accidental damage to the dura mater during epidural anesthesia.

⠀

PDPH occurs when the patient moves to an upright position, often accompanied by dizziness, nausea, and nausea. In severe cases, the pain does not stop when moving to a horizontal position. According to the available literature, PDPH appears within 1-3 days after puncture of the dura mater during spinal anesthesia in 2-3% of cases in general surgical practice and in 5-6% during performing SMA during cesarean section and or almost always after accidental damage to the dura mater during epidural anesthesia.

⠀

The cause of PDPH is most often considered to be a decrease in pressure in the subarachnoid space due to the leakage of cerebrospinal fluid through a post-puncture hole in the dura mater. If the outflow of cerebrospinal fluid occurs at a rate exceeding its production, there is a possibility of displacement of intracranial structures with tension in the meninges, which is especially significant when moving to a vertical position.

⠀

The resulting pain impulses are carried along the trigeminal nerve, glossopharyngeal nerve, branches of the vagus nerve and cervical nerves. There is a high correlation between the diameter of the needle, the frequency of pain and its intensity. The location of the needle cut during puncture is of particular importance. In addition, it has been experimentally revealed that the presence of air introduced into the spinal canal is important. This significantly increases the incidence of PDPH, guaranteed to cause PDPH with just 0.2 ml of air. It is also important to remove the needle with the mandrin inserted. Its absence in a needle or attached syringe doubles the likelihood of developing PDPH.

⠀

More often, PDPH occurs in young women, more often in those with normal or reduced body weight. An increase in intra-abdominal pressure during pregnancy contributes to an increase in cerebrospinal fluid pressure and increases the rate of its flow, which leads to a more frequent development of PDPH.

⠀

There is no consensus on treatment methods for PDPH. All authors recommend strict bed rest if PDPH occurs; in 95% of cases, the effect is achieved by filling the epidural space with autologous blood; with repeated filling with autologous blood, the effect is achieved in 100%. Filling with autologous blood may be accompanied by pain during puncture of the epidural space, muscle spasm during blood injection, and the occurrence of meningeal symptoms. The described phenomena are transient and do not require additional treatment. Prescription of a 20% caffeine solution, intravenous administration of a 40% glucose solution, 25% magnesia solution, and B vitamins can be effective. IV infusion of 1200 ml of saline solutions is often used.

⠀

A relatively new direction is the use of Sphenopalantine block for the treatment of PDPH. According to published data, its effectiveness is comparable to filling the epidural space with autologous blood. According to the authors, the effect occurs within a few minutes and reaches a maximum within 1 hour after administration.

⠀

Such a large number of recommendations for the treatment of PDPH suggests that to date there is no understanding of either the mechanisms or causes of this complication.

Anesthesiologist-reanimatologist Evgeniy Anatolyevich Orlov.

Headache while breastfeeding

The occurrence of headaches during lactation and breastfeeding is often associated with chronic lack of sleep and fatigue of young mothers. These may include tension headaches and migraine pain. By organizing your day and taking frequent rest, such pains go away on their own.

However, for more serious reasons (hypertension, head injuries, infectious diseases), it is necessary to consult a doctor who can examine you for other diseases, such as intercostal neuralgia or sciatica.

Headache in a nursing mother: a guide to medications

Headache... Almost every young woman encounters this ailment from time to time. And most probably know how to quickly eliminate an unpleasant symptom - swallow the appropriate pill. A nursing mother, alas, cannot afford such carelessness. She needs medications that will relieve the pain without harming the baby. But do they exist?

Unfortunately, almost all pharmacological drugs pass into breast milk. This means that any medicine that a nursing mother takes can reach the baby. If the instructions for the drug do not contain information about whether it can be taken during lactation, you should consult your doctor. But there are situations when such consultation is impossible for some reason. To prevent headaches from taking you by surprise, it is useful to learn as much as possible about it, as well as to become more familiar with the medications designed to eliminate this unpleasant symptom.

The many faces of “torture”

Headache can be different - constant and paroxysmal, strong and not very strong, unexpected and slowly developing, increasing; sometimes it acts as an annoying “background” or attacks a person in such attacks that it seems that existence itself is no longer possible. In addition, the head may hurt only in one area (for example, in the temporal region), or it may be covered in pain all over. Complaints of headache can be the main or only symptom of more than 40 different diseases: infections of any origin, the effects of drugs, chemicals or alcohol (for example, contraceptives, nitroglycerin, caffeine, household chemicals), as well as osteochondrosis of the cervical spine[1 ], depression, hypertension (increased blood pressure), hypotension (lowered blood pressure), diseases of the kidneys, nervous system, ENT organs, eyes, etc.

One of the most common forms of headache is tension headache.

(70%). It occurs in response to mental stress, which is the result of acute or chronic stress. In this case, the person experiences a feeling of tightening, squeezing, a “helmet” or “hoop” around the head. As a rule, this pain is diffuse, of weak or moderate intensity, it does not intensify from physical activity. It most often occurs sporadically, so to eliminate it, a “one-time” medication can be taken.

What is possible and what is not

Analgesics (an - negation, algos - pain) are usually used to treat headaches, and the most famous drug in this group is analgin. However, in a number of countries the production and sale of this drug is prohibited, since even its one-time use carries the potential risk of life-threatening complications such as hematopoietic suppression, severe kidney damage, and anaphylactic shock [2].

Therefore, ANALGIN is contraindicated during pregnancy and breastfeeding.

Analgin is also part of a large number of combined painkillers, such as SEDALGIN, PENTALGIN, TEMPALGIN

etc.
In addition, they contain medicinal substances that enhance the analgesic effect. The phenobarbital, codeine phosphate and caffeine contained in SEDALGIN are dangerous for the newborn (as well as for the embryo and fetus). Most of the components pass into breast milk. Phenobarbital may cause central nervous system depression in the newborn. Caffeine will “add” regurgitation, agitation and poor sleep. Codeine can cause depression of the central nervous system in a child, and also interferes with the transport of milk from the alveoli (sacs) of the mammary gland to the ducts. Thus, any drugs containing these components should not be used during breastfeeding.
According to the American Committee on Food and Drug Safety (FDA - Food and Drug Administration), the following analgesics are compatible with breastfeeding:
PARACETAMOL, IBUPROFEN, NAPROXEN, KETOPROFEN. Paracetamol (PANADOL, EFFERALGAN, CALPOL)
acts directly on the pain centers in the brain.
In addition to pain relief, it has an antipyretic effect. Headache is not the main indication for the use of IBUPROFEN, NAPROXEN, KETOPROFEN
; they are more often used for pain and inflammation in the joints.
The effect of these drugs on lactation and the child’s health has not been fully studied, so they should be used with caution during breastfeeding, and if possible, limit it to a single dose.

If the cause is vascular pathology

According to statistics, migraine is the cause of 25% of headaches :

a condition in which attacks of severe throbbing headaches appear in one half of the head, which is caused by spasm of cerebral vessels.
Young women are most often affected by migraines. An attack can be triggered by emotional stress, a long break between meals or drinks, or lack of sleep. In addition to headaches, nausea, vomiting, and sensitivity to light and sound may occur. For the treatment of migraine, the most commonly used drugs are ergot derivatives -

ergotamine
preparations .
This group includes: DIHYDROERGOTAMINE
(Digidergot nasal spray),
ZOMIG
,
RIZATRIPTAN
.

These drugs narrow the intracranial vessels dilated during an attack and reduce the excitability of nerve cells. Adequate and strictly controlled studies of the safety of these drugs in pregnant and lactating women have not been conducted. Therefore, during breastfeeding, the use of the above-mentioned drugs is possible only after consultation with a doctor, if the expected effect of therapy outweighs the potential risk to the child

.

In children whose mothers took ergotamine

, adverse reactions such as nausea, vomiting, and convulsions were reported.
Headache due to arterial hypertension
is not as common as is commonly believed. However, a rise in blood pressure may be accompanied by severe, pressing, throbbing pain in the neck and back of the head. Today, the treatment of hypertension in nursing mothers is a serious problem. The fact is that in modern practice there are no controlled comparative clinical trials with a sufficient number of participants. Many studies have examined only the therapeutic concentrations of drugs in the blood and breast milk, and not the effect on the child.

For example, the duration of breastfeeding was not assessed taking into account the use of medications, and whether the child refused to feed when the mother was taking these medications.

Let's consider the main groups of drugs for the treatment of arterial hypertension, most often used in everyday practice:

1. atenolol, metoprolol, propranolol

(better known as
ANAPRILIN
or
OBZIDAN
),
nebivolol
(
NEBILET
) are representatives of the group of so-called
beta-blockers
that block the functioning of receptors (nerve cells) located in the heart and blood vessels.
As a result, the effect of the hormone norepinephrine on them is prevented, and, as a result, the heart rate slows down and blood pressure decreases. Unfortunately, studies of these drugs have shown high concentrations in breast milk. There have been cases where, when using ATENOLOL
by nursing mothers, children experienced shortness of breath and rapid heartbeat.

Therefore, ATENOLOL is not recommended for use by breastfeeding women.

Relatively low concentrations in breast milk were found for
PROPRANOLOL AND NEBIVOLOL
.
The latter is officially approved for use in pregnant women. As for the use of this medicine during lactation, its effect on the child has not been clearly studied, therefore NEBIVOLOL cannot be recommended for nursing women
.

2. enalapril (ENAP, RENITEK), captopril (CAPOTEN)

belong to the so-called
angiotensin-converting enzyme inhibitors
.
This enzyme promotes the transition of a specific substance - angiotensin I
to
angiotensin II
, which has a pronounced vasoconstrictor effect. Drugs in this group block the enzyme, and the conversion process is inhibited. As a result, the vessels do not narrow and blood pressure does not increase. The inhibitors mentioned are found in the smallest quantities in breast milk. However, recommendations for their use by nursing mothers are contradictory: in the official pharmacological reference books of our country (Register of Medicines of Russia, Vidal), the use of these drugs during pregnancy and breastfeeding is contraindicated, and some foreign sources contain data on their use during lactation.

If a “one-time” headache occurs in a nursing mother, she can take PARACETAMOL once. Any headache that persists for a relatively long time requires evaluation.

If a nursing mother gets sick,

She should follow several rules during treatment:

* do not engage in self-healing. Treatment should only be prescribed by a doctor (not even a pharmacist);

* if it is necessary to choose a drug, one should be guided, first of all, not by the criterion of its effectiveness, but by the degree of safety for the child;

* if the properties of the prescribed drug cause concern to the mother, she should ask the doctor to tell her about the possible effect of the drug on the baby or ask to prescribe an alternative drug;

* when taking pharmacological drugs, it is important to monitor the appearance of side effects in the child (allergies, loose stools, etc.);

* you should make maximum use of the possibilities of gentle treatment: physiotherapeutic methods, restoratives;

* if the use of medications is necessary, then it is better to take them immediately after feeding, before the maximum accumulation of the drug in the blood has occurred;

* if you need to take a medicine that is absolutely not suitable for a nursing mother, breastfeeding will have to be stopped during treatment, and in order to maintain lactation, it is necessary to express and pour out the milk, since these portions will also contain a pharmacological agent. After completing the course of treatment, you can return to breastfeeding.

[1] Osteochondrosis of the spine is a chronic disease caused by thinning of the cartilaginous intervertebral discs, as a result of which the roots of the spinal nerves are compressed, pain in the spine and limitation of movements appear.

[2] Anaphylactic shock is a severe allergic reaction in which, in response to the introduction of any substance into the body, a sharp drop in blood pressure occurs, which disrupts the functioning of the body, in which case immediate resuscitation assistance is required.

Magazine "Mom and Baby"

Author: Svetlana Vavilonskaya, gynecologist, employee of the Department of Clinical Pharmacology, Moscow State Medical Dental University

Treatment of headaches during pregnancy and breastfeeding

The intake and dosage of pain medications should be discussed with your gynecologist. Due to the fact that many painkillers (including analgin and aspirin) have a harmful effect on the unborn child (teratogenic effect), restrictions on the use of medications are introduced during pregnancy. These restrictions remain in case of headaches and during breastfeeding for the reason described above, since all medications pass into milk.

Some of the mild recommended painkillers are paracetamol-based medications.

However, we also emphasize that before treating a headache, it is necessary to identify its cause, so that the headache does not turn out to be a symptom of a tumor in the brain.

In our multidisciplinary clinic you can undergo examination and consult with competent doctors.

Prevention methods

The first months of a child’s life are a huge responsibility and stress. At this time, the mother’s body experiences heavy stress, to which it reacts with a prolonged headache. However, if you follow several recommendations from doctors, you can avoid deterioration in health and other dangerous consequences:

• use pillows and other feeding devices - they relieve stress on the spine;
• eat well, take complexes of vitamins and microelements if necessary;
• take time for walks - a sufficient amount of oxygen is necessary to nourish brain cells;
• Avoid stress and allow yourself periodic rest.

At the Clinical Brain Institute, you can undergo a complete examination, which will allow you to quickly and accurately determine the cause of your headaches. The doctors of our center are specialists of a narrow and broad profile with many years of experience in treating various diseases. The effectiveness of therapy will depend on the timely use of prescribed medications, as well as on the implementation of additional recommendations, including adherence to diet and regular exercise.

Cost of treatment for headaches during pregnancy and breastfeeding: