Is Scopolamine Safe in Breastfeeding

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

Scopolamine or Hyoscine is a alcaloid which is naturally found in several plants among Solanacea family. With a similar chemical structure of Atropine, it shows anti-muscarinic and anti-cholinergic effects (decrease in saliva, bronchial, sweat and gastric secretion, tachycardia, pupil dilation, anti-spasmodic effect on the intestine and urinary tract) Most frequently used formulations contain buthylbromurate, methybromurate and hydrobromurate. Skin patches contain purified Scopolamine. Used for prevention of motion-sickness of the traveler and treatment of nausea, post-anesthesia vomiting. Also, as anti-spasmodict and treatment of ophthalmologic disorders. At latest update, relevant published data on excretion into breast milk were not found. Due to a low oral bioavailability that minimizes the presence into the infant's plasma from mother's milk ingested, thus, the expert consensus is that the risk of use while breastfeeding is minimal. (American Academy of Pediatrics - 2013 says that is usually compatible with breastfeeding) Since at small dosage Scopolamine poisoning with alarming symptoms may occur (irritability, delirium, redness of skin, mouth dryness, constipation, urine retention), we would recommend a cautious and moderate use with a dose as low as possible with a delay of at least 3 hours for breastfeeding after medication. Avoid use if the infant is younger than 2 months or premature.

No information is available on the use of scopolamine during breastfeeding. Use during labor appears to have a detrimental effect on newborn infants' nursing behavior. Long-term use of scopolamine might reduce milk production or milk letdown, but a single systemic or ophthalmic dose is not likely to interfere with breastfeeding. During long-term use, observe for signs of decreased lactation (e.g., insatiety, poor weight gain). To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue.

Anticholinergics can inhibit lactation in animals, apparently by inhibiting growth hormone and oxytocin secretion.[1][2][3][4][5] Anticholinergic drugs can also reduce serum prolactin in nonnursing women.[6] The prolactin level in a mother with established lactation may not affect her ability to breastfeed. A retrospective case-control study conducted in two hospitals in central Iran compared breastfeeding behaviors in the first 2 hours postdelivery by infants of 4 groups of primiparous women with healthy, full-term singleton births who had vaginal deliveries. The groups were those who received no medications during labor, those who received oxytocin plus scopolamine, those who received oxytocin plus meperidine, and those who received oxytocin, scopolamine and meperidine. The infants in the no medication group performed better than those in all other groups, and the oxytocin plus scopolamine group performed better than the groups that had received meperidine.[7]