Is Dichlofenac Safe in Breastfeeding

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

High plasma protein binding makes excretion into breast milk to be very low. Because the latter and a rapid elimination rate it is considered to be compatible with breastfeeding.

Data on excretion of Dichlofenac into milk are poor, but the drug has a short half-life and little glucuronide metabolite formation. Most reviewers consider Dichlofenac to be acceptable during breastfeeding.[1][2][3][4] Other agents having more published information may be preferred, especially while nursing a newborn or preterm infant. Maternal use of Dichlofenac eye drops would not be expected to cause any adverse effects in breastfed infants. 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.

In one study, 30 mothers undergoing elective cesarean section were allowed to use 25 mg Dichlofenac suppositories along with either spinal or spinal and epidural anesthesia with a local anesthetic after delivery. The spinal anesthetic group used an average of 56 mg of Dichlofenac on the day of delivery and 33 mg on the next day whereas the women receiving both spinal and epidural anesthesia used 21 and 18 mg. No mention was made of adverse effects on the breastfed infants.[8] An breastfed infant developed urticaria on day 15 of life. Her mother had been taking Dichlofenac (dosage unspecified) for pain since her cesarean section delivery. Dichlofenac is a possible cause of the urticaria; however, the infant had also received hepatitis B vaccination 7 days before and the authors thought that it was a more likely cause of the reaction.[9]