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Breastfeeding and management of anal fissures or piles

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Haemorrhoids and anal fissures occur in about 40% of pregnant women and women after delivery, usually in the third trimester of pregnancy and 1–2 days after giving birth (1):

  • constipation during pregnancy, perianal diseases during previous pregnancy and childbirth, instrumental delivery, straining duration of more than 20 min, and newborn weight of more than 3,800 g are associated with haemorrhoids.

Topical rectal and anal preparations are compatible with breastfeeding, and the choice of product will depend on the indication (2):

  • for anal fissures
    • glyceryl trinitrate rectal ointment and diltiazem cream or ointment (unlicensed) may be used during breastfeeding.
  • haemorrhoids and related conditions
    • local anaesthetics (such as cinchocaine or lidocaine), corticosteroids (such as hydrocortisone or prednisolone) and zinc oxide may be used topically and rectally to treat haemorrhoids and related conditions during breastfeeding, and they are often available as combination products
      • some of the commonly-used products (Anusol products, Germoloids, Proctosedyl, Scheriproct, Uniroid-HC, Xyloproct) contain additional ingredients such as bismuth compounds, peru balsam or benzyl benzoate
      • due to the low dose of medication contained, small application area and minimal absorption, they are compatible with breastfeeding.


  1. Bužinskienė D, Sabonytė-Balšaitienė Ž, Poškus T. Perianal Diseases in Pregnancy and After Childbirth: Frequency, Risk Factors, Impact on Women's Quality of Life and Treatment Methods. Front Surg. 2022 Feb 18;9:788823.
  2. NHS Specialist Pharmacy Service (March 19th 2024). Treating rectal and anal disorders during breastfeeding

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