Gastrointestinal antispasmodics during breastfeeding

A review states (1):

• hyoscine butylbromide, propantheline or peppermint oil are considered preferred choices in breastfeeding
  • mebeverine and alverine can also be used
• there is limited evidence for the use of antispasmodics during breastfeeding, and therefore recommendations are generally made on the properties of the medicine
  • the choice of medicine will depend on symptoms
  • there is a theoretical risk that suppression of breast milk production could occur with antimuscarinic drugs (atropine, hyoscine butylbromide, propantheline)
  • there have been conflicting reports that peppermint may increase or decrease breast milk production
    • there is no published evidence to support this
• once breastfeeding is established, any effect on breast milk production becomes less significant
• it is advisable to monitor breastfed infants for adequate feeding and poor weight gain, especially if used long-term

Reference:

1. NHS Specialist Pharmacy Service (March 8th 2024). Using gastrointestinal antispasmodics during breastfeeding.