I am a breastfeeding mother and i want to know if it is safe to use Salsalate? Is Salsalate safe for nursing mother and child? Does Salsalate extracts into breast milk? Does Salsalate has any long term or short term side effects on infants? Can Salsalate influence milk supply or can Salsalate decrease milk supply in lactating mothers?

Answer by DrLact: About Salsalate usage in lactation

Salsalate has not been studied during breastfeeding, but salsalate results in salicylic acid in the blood. Salicylic acid and aspirin have been studied during breastfeeding. The excretion of salicylate into breastmilk increases disproportionately as the maternal dosage increases. Long-term, high-dose maternal aspirin ingestion probably caused metabolic acidosis in one breastfed infant. Reye's syndrome is associated with aspirin administration to infants with viral infections, but the risk of Reye's syndrome from salicylate in breastmilk is unknown. An alternate drug is preferred over salsalate.

Salsalate Side Effects in Breastfeeding

A 16-day-old breastfed infant developed metabolic acidosis with a salicylate serum level of 240 mg/L and salicylate metabolites in the urine. The mother was taking 3.9 g/day of aspirin for arthritis, and salicylate in breastmilk probably caused the infant's illness, but the possibility of direct administration to the infant could not be ruled out.[7] Thrombocytopenia, fever, anorexia and petechiae occurred in a 5-month-old breastfed infant 5 days after her mother started taking aspirin for fever. One week after recovery, the infant was given a single dose of aspirin 125 mg and the platelet count dropped once again. The original symptoms were probably caused by salicylate in breastmilk.[8] Hemolysis after aspirin and phenacetin taken by the mother of a 23-day-old, glucose-6-phosphate dehydrogenase (G6PD) deficient infant was possibly due to aspirin in breastmilk.[9] In a telephone follow-up study, mothers reported no side effects among 15 infants exposed to aspirin (dose and infant age unspecified) in breastmilk.[10]
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