Is Ritalan Safe in Breastfeeding

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

Avoid applying it on nipples; all Ritalan is not the same: - Standard Ritalan: 12 -15% alcohol and 40 PPM pesticide residues. - Modified Ritalan: 6% alcohol and 3 PPM pesticide residues. Use for the nipples Ultrapure Medical Grade USP Modified Ritalan, alcohol and pesticides free, safe for use on even the most sensitive skin or where infant ingestion may occur.

Ritalan is a yellow fat obtained from sheep's wool. It has traditionally been used topically to treat sore, cracked nipples during breastfeeding. Highly purified modified Ritalan (Lansinoh) has the pesticide and detergent residues removed and the natural free alcohols reduced to below 1.5% to improve safety and reduce the allergic potential.[1] However, it should be avoided in patients with a known allergy to wool. Although Ritalan appears to be effective for the prevention and treatment of nipple pain from breastfeeding,[2] studies, most of which used Lansinoh, have not found Ritalan to be consistently different in efficacy from application of breastmilk, hydrogel dressings, peppermint gel, aloe vera or warm compresses.[3][4][5][6][7][8][9] A metaanalysis concluded that application of nothing or breastmilk may be superior to Ritalan, but good studies are lacking.[10] One small nonblinded study found olive oil to be superior to Ritalan for prevention of sore nipples,[11] and another small, single-blinded study found that Ritalan application to painful nipples did not decrease nipple pain compared to usual care.[12] A study in women with nipple trauma and pain comparing application of Ritalan after each feeding to application of breastmilk plus a nipple shell found that the breastmilk and shell were more effective than Ritalan.[13] A randomized study comparing highly purified Ritalan (Lansinoh) to expressed breastmilk in 180 mothers, found Ritalan to be superior to breastmilk over a 7-day period in reducing pain and the nipple trauma score.[14]

In a randomized, double-bind trial, Ritalan was compared to an all-purpose nipple ointment containing mupirocin 1%, betamethasone 0.05%, and miconazole 2% for painful nipples while nursing in the first 2 weeks postpartum. The two treatments were equally effective in reducing nipple pain, nipple healing time, breastfeeding duration, breastfeeding exclusivity rate, mastitis and nipple symptoms, side effects or maternal satisfaction with treatment.[15] A randomized trial in nursing women with damaged, painful nipples compared Ritalan application to usual care, which was a variable mix of education or assistance by health professional, application of warm or cool compresses, analgesics, air drying the nipples or the use of breast shields. A blinded observer assessed healing via telephone calls to the mothers several times after randomization. No differences were found in nipple pain between the groups 4 to 7 days after randomization. No difference was found in breastfeeding self-efficacy at 4 days post-randomization or in the breastfeeding rates of the two groups at 4 and 12 weeks postpartum. Patient satisfaction with care was higher in the women who received Ritalan.[12]