RU-486/mifepristone & breastfeeding? - Mothering Forums
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#1 of 16 Old 08-19-2005, 01:18 PM - Thread Starter
 
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Does anyone know if RU-486, or mifepristone (also called mifeprex) can be taken while breastfeeding? It is, obviously, a one-time dose, so if the baby can't be exposed, how long would one have to pump-and-discard?
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#2 of 16 Old 08-19-2005, 05:06 PM
 
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I would definitely NOT nurse for *at least* 3 days after taking Mifepristone. It is highly likely that it is excreted in breastmilk due to the fact that other prostaglandins like it are. And it stays in the bloodstream for a long time (up to 11 days) with high concentrations for up to 72 hours. Animal studies and human reports demonstrate concerns re normal cell growth and development.


Here's the label...

http://www.fda.gov/cder/foi/label/20...bl_Revised.pdf


Quote:
Following a distribution phase, elimination of mifepristone is slow at first (50% eliminated between 12 and 72 hours) and then becomes more rapid with a terminal
elimination half-life of 18 hours.
Quote:
The onset of puberty was observed to be slightly premature in female rats neonatally exposed to
mifepristone. In a separate study in rats, oviduct and ovary malformations in female rats, delayed male puberty, deficient male sexual behavior, reduced testicular size, and lowered ejaculation frequency were noted after exposure to mifepristone (1 mg every other day) as neonates.
Quote:
Several reports in the literature indicate that prostaglandins, including misoprostol, may have teratogenic effects in human beings. Skull defects, cranial nerve palsies, delayed growth and psychomotor development, facial malformation and limb defects have all been reported after
exposure during the first trimester.
Quote:
It is not known whether mifepristone is excreted in human milk. Many hormones with a similar chemical structure, however, are excreted in breast milk. Since the effects of mifepristone on infants are unknown, breast-feeding women should consult with their health care provider to decide if they should discard their breast milk for a few days following administration of the medications.
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#3 of 16 Old 08-19-2005, 07:44 PM
 
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Wow, scary. And to think someone would put that into their OWN body, much less their baby's body. Hmmmmmm. :

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#4 of 16 Old 08-19-2005, 07:59 PM
 
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I highly doubt anyone who is breastfeeding and who needs to take RU-486 is doing so lightly. It must be a wrenching decision to make. Judgment concerning a situation we know nothing about doesn't help.
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#5 of 16 Old 08-20-2005, 12:08 AM
 
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Leave her alone, faerybug.
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#6 of 16 Old 08-20-2005, 01:08 AM
 
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I did a search for mifepristone at Dr Hale's site. http://66.230.33.248/discus/messages/52/3718.html (you may have to sign in as a guest and repaste the address.) Here's what he says:

"We do not have data on the transfer of RU-486(mifepristone) into human milk. That said, it has a steroid-like structure, it penetrates the CNS and amniotic fluid extremely poorly, and it is highly protein bound (98%). Thus I would guess that its transfer into milk would be minimal to virtually nothing.

"Mifepristone is a potent inhibitor of the progestin receptor. Interestingly, it has actually be used in monkeys postnatally to stimulate milk production due to its effect on the progestin receptor. So I really doubt it would transfer significantly to a breastfeeding infant, nor would it likely produce side effects in such an infant even if it did.

Tom Hale Ph.D."

http://66.230.33.248/discus/messages/52/3718.html

It sounds like it would be OK for the baby, but in my search, I came across some nasty side-effects that would concern me for YOUR health. I'm not sure how I feel about those, but if this is the best route for YOU (money-wise, emotionally, etc, compared to other methods), then you need to do what you think is best. But make sure you're well-informed on the common side-effects. I know my sister took this drug with little problem a few years ago. But she wasn't nursing.
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#7 of 16 Old 08-20-2005, 01:22 AM - Thread Starter
 
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Thanks for the supportive replies.

Do you know, people have private message-d me rather than "risk" replying on the board, because they're afraid of being exposed and having hostile judgements cast on them, where they otherwise feel at home and in community? *They* only wanted to answer as fully as possible, and felt unable to do so.

So: some of the "incognito" replies I have received (from real, live mdc women who have needed to use RU486 while nursing, and for whom it might or might not have been a difficult decision) have said that they used the mifeprex and continued breastfeeding with no obvious effects, and no recommendations not to nurse. Does anyone reading currently know of any written data on this? Thanks in advance, and obviously PM me if preferred.
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#8 of 16 Old 08-20-2005, 01:38 AM - Thread Starter
 
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FWIW I will add that I have been asked this question many times over the years, and while I have read what I've been able to find online I haven't heard many first-hand stories. Nor should anyone assume this question is for me. Thanks again to everyone .
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#9 of 16 Old 08-20-2005, 01:46 AM
 
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Someone asked the same question on here a year or so ago- have you searched to see if you turn anything up?

-Angela
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#10 of 16 Old 08-20-2005, 11:04 AM
 
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Liz, I am so sad to hear that exceptional judgmentalism (as evidenced on this thread) would drive people into secrecy, for fear of being--what? Judged? Attacked?

This is supposed to be a supportive community. The snarky comment from faerybug was uncalled for. I hope that the stories people shared with you privately help whomever you are helping. And I, personally, would like to let those who PMd you know that I don't judge them or anyone who has to make such a tough decision. The fact that someone is nursing a child and is concerned about the effect of the drug on their nursling shows that they are a very involved and caring parent. (((HUGS)))
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#11 of 16 Old 08-20-2005, 11:37 AM
 
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Life has taught "me" do not judge someone until you have walked in their shoes. I dont have any data on the subject but to you in your decisions. My gut feeling would be pump and dump for a few days ( hoping you have a frozen stash : Good luck in your research.

Jeana Christian momma to 4 sons Logan 18, Connor 15, Nathan 6, and bonus baby Jack 1
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#12 of 16 Old 08-20-2005, 01:23 PM
 
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Liz,

I honestly would go by the actual drug label and extrapolate what it says using a similar type drug structure like what peri posted.

A lot of times we do not know the effects until too late. I know some momma's have pm'd you that they used it without any ill effects to the baby but it's truly a guessing game if you read the drug's label. It's a guessing game that I would not really like to play.

It is much better to be safe than sorry for a few days and it won't hurt the baby to be put on something nutritious for a few days (and pumping to keep up supply) vs. chancing that it may cross into breast milk into a rapidly growing and forming baby.

Quote:
hoping you have a frozen stash
haha I keep hearing that stashes exist...but I've yet to get that much of that "liquid gold" out of my boobs for more than one feeding LOL!


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#13 of 16 Old 08-20-2005, 05:27 PM
 
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Quote:
Originally Posted by gurumama
Liz, I am so sad to hear that exceptional judgmentalism (as evidenced on this thread) would drive people into secrecy, for fear of being--what? Judged? Attacked?
I too am actually shocked to read people fear being attacked. But then there it is right here in black and white. :

Quote:
Originally Posted by Sherra
I honestly would go by the actual drug label and extrapolate what it says using a similar type drug structure like what peri posted.
I've seen dramatic inconsistencies before in Hale's. (And I love this resource and am grateful to it, but I wonder sometimes how anything can be 100% accurate and up to date, kwim, or where the stuff comes from at all). Mifepristone is a prostaglandin, and these hormones are well known to cross into the milk. Whether or not it would impact an infant is another story, but there is a wealth of evidence that it would impact a developing fetus. To me... if it can hurt a fetus, I'd have concerns about it harming a fast-growing, immature-system infant as well.

To be safe, I think the most prudent thing would be pump and dump for 2-3 days -- 24 hours MINIMUM (the stuff has a seriously long clearance rate from the body) -- and use your own EBM or donated milk during that time. I know I would be more than happy to pump to donate a few ounces (I have a huge hungry baby so I couldn't get more than that to spare!) and other mamas here have frozen EBM too.

Best of luck in your choice.
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#14 of 16 Old 08-22-2005, 08:13 AM
 
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Quote:
Originally Posted by wannabe
Leave her alone, faerybug.

Wow that's truly interesting that I get chastised for wanting to keep babies' bodies chemical-free and safe while nursing. Wonder if I would be flamed as much for formula-feeding too? Or is it okay to expose your baby to hazardous chemicals as long as you are nursing and avoiding that "evil" chemical formula??? :

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#15 of 16 Old 08-22-2005, 02:56 PM
 
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Quote:
Originally Posted by faerybugmady
Wow, scary. And to think someone would put that into their OWN body, much less their baby's body. Hmmmmmm. :
So I see at least you're embarrassed to have been so horribly judgemental

If you had been concerned about transmission to the baby in milk you would have said something like "I'd pump and dump for at least a week or more, just to be safe, and I'd choose surgery instead of the medical termination", and you would have gotten on medline and tried to find info about half-life of the drug in your system.

But no, you offered no helpful advice, just snarky remarks and value judgements. Do you do the same thing when women choose to take pain releif after a caesarean birth>
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#16 of 16 Old 07-08-2013, 06:23 PM
 
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Here's a specific study on breastfeeding and Mifepristone.

 

http://www.ncbi.nlm.nih.gov/pubmed/20367522

 

CONCLUSIONS:

The levels of mifepristone in milk are low, especially when using the 200 mg dose. Breastfeeding can be safely continued in an uninterrupted manner during medical abortion of this kind.


Mom to MacLane (9), Orion (7), Amadeus (5), and Alexandria (due in Sept).belly.gif

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