can mothers breastfeed after a medical termination of pregnancy?
Last edited 10/2023 and last reviewed 10/2023
Medically terminating a pregnancy during breastfeeding
Mifepristone and misoprostol are recommended for medical termination of pregnancy (abortion) (1)
- are often given as single doses, with mifepristone being administered first, followed by misoprostol; although further doses of misoprostol may be required.
- as there are negligible amounts for each medicine found in breast milk and the risk of accumulation in the infant is minimal, they are considered compatible with breast feeding.
- there are no data on the direct effect of mifepristone or misoprostol on the lactation process.
- gemeprost is no longer routinely recommended
- a review states that breastfeeding and multi-fetal pregnancies are not contraindications to medical termination (2)
- previous guidance stated that as a precaution,infants exposed to mifepristone or misoprostol via breastmilk should be monitored for nausea, vomiting and poor feeding (3)
Mifepristone use in breasfeeding:
- use with caution
- mifepristone can be used during breastfeeding due to negligible levels in milk.
- infant monitoring
- as a precaution, monitor the infant for nausea, vomiting, diarrhoea and poor feeding.
- further information
- limited data suggest that the levels of mifepristone in milk are negligible when single doses of up to 600mg have been administered
- breastfeeding can continue in an uninterrupted manner during medical termination.
- no side effects have been reported for infants after exposure to mifepristone via breast milk
- limited data suggest that the levels of mifepristone in milk are negligible when single doses of up to 600mg have been administered
- use with caution
- misoprostol can be used during breastfeeding due to negligible levels in milk.
- infant monitoring
- as a precaution, monitor the infant for nausea, vomiting, diarrhoea and poor feeding.
- further information
- oral misoprostol is excreted into breast milk in negligible to very small amounts when doses up to 600mg have been administered, which are rapidly eliminated.
- although there is no evidence for vaginal or rectal administration, similar low levels are anticipated in breast milk.
- no interruption of breastfeeding is necessary when misoprostol is given by any route, or if repeated doses are required in the short term
- no side effects have been reported for infants after exposure to misoprostol via breast milk
Reference:
- NHS Specialist Pharmacy Service (September 2023). Medically terminating a pregnancy during breastfeeding
- Bateson D, McNamee K, Harvey C. Medical abortion in primary care. Aust Prescr. 2021 Dec;44(6):187-192. doi: 10.18773/austprescr.2021.050. Epub 2021 Dec 1. PMID: 35002030; PMCID: PMC8671011
- NHS Specialist Pharmacy Service (October 15th 2020). Can mothers breastfeed after a medical termination of pregnancy?