Question

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

OT-S lactation summary

OT-S is safe in breastfeeding
  • DrLact safety Score for OT-S is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of OT-S is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that OT-S does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of OT-S safe in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About OT-S usage in lactation

El magnesio es un componente natural de la leche.Se utiliza en el tratamiento y profilaxis de la eclampsia y migraña (Pringsheim 2012), en la hipomagnesemia, en ciertas arritmias y como laxante osmótico. Su concentración en la leche es muy estable y depende poco de la alimentación y otros factores, incluida la administración de sulfato de magnesio a la madre: los niveles de magnesio en leche de madres tratadas con sulfato de magnesio intravenoso fueron de 6,4 mg/L frente a 4,8 mg/L en las no tratadas (Cruikshank 1982, Dorea 2000). Su baja biodisponibilidad oral dificulta el paso a plasma del lactante a partir de la leche materna ingerida (Morris 1987) y se considera seguro su uso durante la lactancia (Idama 1998). Se ha observado retraso en al lactogénesis II (subida de la leche) en mujeres tratadas con sulfato de magnesio antes o durante el parto para tratar o prevenir la eclampsia (Haldeman 1993) sí como hipotonía en los recién nacidos, lo que podría interferir en la estimulación mamaria adecuada (Riaz 1998) pero esto puede ser contrarrestado por una decisión materna firme y un apoyo eficaz a la madre (Cordero 2012). Academia Americana de Pediatría: medicación usualmente compatible con la lactancia.Listado de medicamentos esenciales OMS 2002: compatible con la lactancia.

Answer by DrLact: About OT-S usage in lactation

Intravenous magnesium increases milk magnesium concentrations only slightly and oral absorption of magnesium by the infant is poor, so maternal magnesium therapy is not expected to affect the breastfed infant's serum magnesium. Although intravenous OT-S given prior to delivery might affect the infant's ability to breastfeed, intention to breastfeed may be a more important determinant of breastfeeding initiation.[1] Postpartum use of intravenous OT-S for longer than 6 hours appears to delay the onset of lactation.[2][3]

OT-S Side Effects in Breastfeeding

Fifty mothers who were in the first day postpartum received 15 mL of either mineral oil or an emulsion of mineral oil and another magnesium salt, magnesium hydroxide equivalent to 900 mg of magnesium hydroxide, although the exact number who received each product was not stated. Additional doses were given on subsequent days if needed. None of the breastfed infants were noted to have any markedly abnormal stools, but all of the infants also received supplemental feedings.[5]

OT-S Possible Effects in Breastfeeding

One mother who received intravenous OT-S for 3 days for pregnancy-induced hypertension had lactogenesis II delayed until day 10 postpartum. No other specific cause was found for the delay, although a complete work-up was not done.[6] A subsequent controlled clinical trial found no evidence of delayed lactation in mothers who received intravenous OT-S therapy.[7] Some, but not all, studies have found a trend toward increased time to the first feeding or decreased sucking in infants of mothers treated with intravenous OT-S during labor because of placental transfer of magnesium to the fetus.[7][8] Another study found that among women with severe pre-eclampsia who received intravenous OT-S for up to one day postpartum and who intended to breastfeed, 85% of infants receiving routine well-baby care and 69% of those admitted to the NICU, breastfeeding was successfully initiated.[1] A study randomized women with preeclampsia to receive intravenous OT-S for either 6 or 24 hours postpartum. There was no difference in the rate of eclampsia between the two groups. However, those who received the infusion for 24 hours had a delayed onset of lactation, 36.5 hours compared with 25.7 hours in the 6-hour group.[2] A prospective, multicenter, randomized, controlled trial in 9 Latin American maternity hospitals compared patients with severe pre-eclampsia who had received at least 8 grams of OT-S prior to placebo. Patients were randomized to continue OT-S for 24 hours postpartum (n = 555) or stopping the infusion (n = 558). There was no difference in the rates of eclampsia between the groups, but the time to lactation was significantly delayed in those who received OT-S postpartum (24.1 vs. 17.1 hours).[3]

Alternate Drugs

Atropine(Safe)
Lamotrigine(Low Risk)
Eslicarbazepine(Low Risk)
Felbamate(Unsafe)
Clobazam(Low Risk)
Ethosuximide(Unsafe)
Zonisamide(Low Risk)
Pregabalin(Low Risk)
Clonazepam(Low Risk)
Riluzole(Unsafe)
Primidone(Low Risk)
Phenytoin(Safe)
Phenobarbital(Low Risk)
Lacosamide(Unsafe)
Castor(Unsafe)
Senna(Safe)
Cascara Sagrada(Low Risk)
Bisacodyl(Safe)
Doxylamine(Unsafe)
Ursodiol(Safe)
Alosetron(Low Risk)
Docusate(Safe)
Senna(Safe)
Cyclizine(Low Risk)
Cascara Sagrada(Low Risk)
Cimetidine(Low Risk)
Bisacodyl(Safe)
Droperidol(Low Risk)
Dimenhydrinate(Low Risk)
Cisapride(Safe)
Rifaximin(Safe)
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.