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Can mothers breastfeed after a medical termination of pregnancy?

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

Misoprostol use in breastfeeding

  • 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:

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