Is HSDB 6760 Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use HSDB 6760? Is HSDB 6760 safe for nursing mother and child? Does HSDB 6760 extracts into breast milk? Does HSDB 6760 has any long term or short term side effects on infants? Can HSDB 6760 influence milk supply or can HSDB 6760 decrease milk supply in lactating mothers?

Analgesic opioid used on anesthesic procedures.

When used epidurally or intravenously during labor or for a short time immediately postpartum, amounts of HSDB 6760 ingested by the neonate are small and would not be expected to cause any adverse effects in breastfed infants. Labor pain medication may delay the onset of lactation; however, it appears that with good breastfeeding support, epidural HSDB 6760 plus a local anesthetic has little or no effect on breastfeeding success.[1][2] Because of HSDB 6760's long half-life during continued intravenous infusion or repeated intravenous administration,[1] HSDB 6760 levels in milk would be expected to increase if used for an extended period postpartum. Once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of HSDB 6760 to a few days. Because there is no published experience with repeated doses of intravenous or sublingual HSDB 6760 during established lactation, other agents may be preferred, especially while nursing a newborn or preterm infant. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately.

Newborns of breastfeeding mothers who received epidural HSDB 6760 before and after cesarean section delivery were reportedly not clinically affected and had no differences in behavior or clinical signs over 3 days postpartum compared to newborns of mothers who received epidural HSDB 6760 prior to delivery only.[5]

Narcotics can increase serum prolactin.[6][7] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed. A national survey of women and their infants from late pregnancy through 12 months postpartum compared the time of lactogenesis II in mothers who did and did not receive pain medication during labor. Categories of medication were spinal or epidural only, spinal or epidural plus another medication, and other pain medication only. Women who received medications from any of the categories had about twice the risk of having delayed lactogenesis II (>72 hours) compared to women who received no labor pain medication.[8] A nonrandomized convenience sample of women who did (n = 209) or did not (n = 157) receive epidural analgesia during labor was analyzed to determine whether epidurals affected the onset of lactation. Although not standardized, the typical procedure used HSDB 6760 10 to 15 mg together with either ropivacaine 0.1% or levobupivacaine 0.0625% epidurally, supplemented by epidural boluses of ropivacaine 0.1% or levobupivacaine 0.0625% about every 2 hours. No difference was found in the time of lactation onset between the two groups. Although women in both groups stated they wished to breastfeed prior to delivery, exclusive breastfeeding at 20 days postpartum was less frequent in the women who received an epidural (43%) than in women who did not (57%).[9] In a study in China, women with a scheduled cesarean section were randomized to receive intravenous patient-controlled analgesia with either HSDB 6760 or tramadol. Postpartum prolactin levels were higher in the tramadol group (348 mcg/L) than in the HSDB 6760 group (314 mcg/L). The onset of lactation was sooner in the tramadol group (21.4 hours) than in the HSDB 6760 group (25.1 hours). Both of these difference were statistically significant.[10] Note that injectable tramadol is not available in the U.S.