If you have any questions about this information, you can contact the Drugs in Breastmilk team through their Facebook page or on druginformation@breastfeedingnetwork.org.uk.
If you have haemorrhoids, you should try to avoid constipation as this will make them worse.
Over-the-counter remedies and steriod creams for haemorrhoids are compatible with breastfeeding.
Haemorrhoids (piles) occur frequently as a result of increased abdominal pressure during pregnancy or a prolonged second stage of labour. If you are experiencing haemorrhoids, you should eat additional fruit and fibre and drink plenty of fluids in order to avoid constipation. If necessary, a bulk laxative such as Fybogel®, lactulose or a stool softener such as docusate (which are all safe to be used whist breastfeeding – see our factsheet on constipation) can be useful on a temporary basis.
For further information on constipation, see https://patient.info/digestive-health/constipation.
Pain Relief
Creams, ointments and suppositories do not cure haemorrhoids but do help with the symptoms of pain and irritation. They often contain a local anaesthetic which limits use to seven days, after which time increased sensitisation from the ingredient may occur.
Ice packs, or the application of bags of frozen peas suitably wrapped, can also help to relieve swelling. Take care not to burn your skin by applying frozen agents directly.
Prescribed creams and suppositories may include a corticosteroid to reduce inflammation – this will not produce clinically significant levels in breastmilk.
Painkillers (analgesics) may be needed in cases of severe pain – products containing codeine should be avoided as they are not recommended whilst breastfeeding and can cause constipation which results in additional straining and further irritation of haemorrhoids. Paracetamol is an ideal choice taken regularly at normal doses. See our factsheet on pain relief for more information.
Treatment
You can use products to treat haemorrhoids without affecting breastfeeding. The absorption of the ingredient drugs from the rectum will not produce significant levels in breastmilk and can be used as necessary for your comfort (morning and night and after bowel motions).
There are a variety of commercially available creams, ointments and suppositories all compatible with breastfeeding: Anusol®, Anusol HC®, Proctosedyl®, Germoloids®, Hemocane®, Preparation H®, Xyloproct®, Ultrproct®, Scheriproct®.
Anal fissures
In severe cases, you may develop anal fissures which do not heal and produce severe pain. This may be treated with glyceryl trinitrate ointment 0.2% or 0.4%. You may experience a headache but there are no reports of adverse effects in babies whose mothers have applied it (Taylor 2008, UKMI). Use during breastfeeding is unlicensed (see our page on patient information leaflets for more information). It is assumed that diltiazem cream would similarly not affect your baby but no research has been identified.
Related Factsheets
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The Breastfeeding Network is a registered Charity (SC027007). We work within the scope of the WHO Code of Marketing of Breastmilk Substitutes, so we do not accept funding from any source with a commercial interest in infant feeding. This means families can trust that the information and support we give is never biased.
Bibliography
Click to see bibliography
British National Formulary: https://bnf.nice.org.uk/
Hale TW, Medication and Mothers Milk. www.halesmeds.com
Jones W Breastfeeding and Medication, Routlege, 2018
LactMed database: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Specialist Pharmacist Service. Treating rectal and anal disorders during breastfeeding, 2024. https://www.sps.nhs.uk/articles/treating-rectal-and-anal-disorders-during-breastfeeding/
Taylor T, Kennedy D. Safety of topical glyceryl trinitrate in the treatment of anal fissure in breastfeeding women. Birth Defects Research Part a-Clinical and Molecular Teratology. 2008;82:411. Abstract.
©The Breastfeeding Network. Originally published May 2020, last updated December 2025
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