Is Metoprolol Safe in Breastfeeding

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

It is excreted into breast milk in non-significant amount without side-effects observed among infants whose mothers were taking this medication. Plasma levels in those infants were very low or undetectable. The American Academy of Pediatrics says that it is usually compatible with breastfeeding.

Because of the low levels of metoprolol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. Studies on the use of metoprolol during breastfeeding have found no adverse reactions in breastfed infants. No special precautions are required.

A study of mothers taking beta-blockers during nursing found a numerically, but not statistically significant increased number of adverse reactions in those taking any beta-blocker. Although the ages of infants were matched to control infants, the ages of the affected infants were not stated. Of 6 mothers taking metoprolol, none reported adverse effects in her breastfed infant.[11][12]

Relevant published information on the effects of beta-blockade or metoprolol during normal lactation was not found as of the revision date. A study in 6 patients with hyperprolactinemia and galactorrhea found no changes in serum prolactin levels following beta-adrenergic blockade with propranolol.[13]