Scopolamine and Breastfeeding

Summary of use during lactation

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.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Anticholinergics can inhibit lactation in animals, apparently by inhibiting growth hormone and oxytocin secretion.[1-5] 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]

References

1. Aaron DK, Ely DG, Deweese WP, et al. Reducing milk production in ewes at weaning using restricted feeding and methscopolamine bromide. J Anim Sci 1997;75:1434-42.9250502 PubMed
2. Powell MR, Keisler DH. A potential strategy for decreasing milk production in the ewe at weaning using a growth hormone release blocker. J Anim Sci 1995;73:1901-5.7592071 PubMed
3. Daniel JA, Thomas MG, Powell MR, et al. Methscopolamine bromide blocks hypothalmic-stimulated release of growth hormone in ewes. J Anim Sci 1997;75:1359-62.9159285 PubMed
4. Bizzarro A, Iannucci F, Tolino A, et al. Inhibiting effect of atropine on prolactin blood levels after stimulation with TRH. Clin Exp Obstet Gynecol 1980;7:108-11.6788407 PubMed
5. Svennersten K, Nelson L, Juvnäs-Moberg K. Atropinization decreases oxytocin secretion in dairy cows. Acta Physiol Scand 1992;145:193-4.1636447 PubMed
6. Masala A, Alagna S, Devilla L, et al. Muscarinic receptor blockade by pirenzepine: Effect on prolactin secretion in man. J Endocrinol Invest 1982;5:53-5.6808052 PubMed
7. Hemati Z, Abdollahi M, Broumand S, et al. Association between newborns' breastfeeding behaviors in the first two hours after birth and drugs used for their mothers in labor. Iran J Child Neurol 2018;12:33-40.29696044 PubMed