Is Terbutaline Safe in Breastfeeding

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

It is excreted into breast milk in clinically non-significant amount and neither clinical nor development problems were observed in infants whose mothers were treated with oral terbutaline.Plasma levels of these infants were undetectable or very low. Preferable preparations are inhaled bronchodilators since <10% of the dose is absorbed. American Academy of Pediatrics: medication usually compatible with breastfeeding.

Maternal use of oral or inhaled terbutaline is unlikely to affect a breastfed infant. The authors of several reviews and an expert panel agree that use of inhaled bronchodilators is acceptable during breastfeeding because of the low bioavailability and maternal serum levels after use.[1][2][3][4][5] Terbutaline use as a tocolytic agent might decrease the duration of breastfeeding.

Two papers have reported a total of 4 infants aged 3 to 8 weeks who were breastfed during maternal use of oral terbutaline 2.5 or 5 mg three times daily. None of the infants had any signs of sympathetic stimulation and all were developing normally.[6][7] These cases were also summarized in a third publication.[8]

A small retrospective survey from Serbia found that mothers who received a beta agonist pharmacologically similar to terbutaline (fenoterol or hexoprenaline) as a tocolytic breastfed for a shorter period of time than those who received no tocolytic (4.5 vs 9.5 months).[9] It is not known if terbutaline has a similar effect.