A: The current available evidence suggests that for the current dose of Mifegymiso, breastfeeding does not need to be interrupted.

The background information is from the National Library of Medicine LactMed database and from the National Abortion Federation Protocol for Mifepristone / misoprostol for Early Medical Abortion, in case you want the details. Hope this is helpful. Sheila Dunn.

Mifepristone Summary of Use during Lactation (NLM):

Limited information indicates that breastfeeding need not be interrupted after a single dose of mifepristone. A dose of 200 mg might be preferable to a 600 mg dose in nursing mothers

Drug Levels:

Maternal Levels. Twelve women (most 6 to 12 months postpartum) who had undergone a medical abortion using mifepristone and misoprostol provided milk samples for up to 5 days after the procedure for measurement of mifepristone. In the 2 women who received a single dose of 200 mg orally, mifepristone was undetectable (<5.6 mcg/L) in breastmilk at all times. Among the 10 women who received a single oral dose of 600 mg, average mifepristone breastmilk levels were 172 mcg/L on day 1 (n = 9); 66 mcg/L on day 2 (n = 9); 31 mcg/L on day 3 (n = 10); 24 mcg/L on day 4 (n = 4); and, 25 mcg/L on day 5 (n = 3). Breastmilk levels of mifepristone were highest in the samples collected between 6 and 9 hours after drug administration. Samples collected between 9 and 15 hours after the dose had much lower mifepristone levels. The authors estimated that a fully breastfed infant would receive a weight-adjusted dosage of 0.5% of the maternal dosage. They suggested that breastfeeding need not be interrupted after a single dose of mifepristone and that a dose of 200 mg might be preferable to a 600 mg dose in nursing mothers^[26].

Misoprostol Summary:

Misoprostol is a prostaglandin E1 analogue. Prostaglandin E1 and other prostaglandins appear normally in colostrum and milk^[27-29]. Because of the low levels of misoprostol in breastmilk, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required.

No evidence supports pumping and discarding of breast milk while undergoing the medical abortion. Mifepristone levels in breast milk after a mother receives 600 mg of mifepristone are low and are undetectable after a 200 mg dose. Levels of misoprostol in breast milk are also low, and the small amounts ingested by infants should not cause any adverse effects^[26]. (National Abortion Federation, revised April 2016).