Is Alfentanil safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Alfentanil. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Relevant published information was not found as of the revision date.
Effects on milk supply
Narcotics can increase serum prolactin.[ 2 , 3 ] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed. A national survey of women and their infants from late pregnancy through 12 months postpartum compared the time of lactogenesis II in mothers who did and did not receive pain medication during labor. Categories of medication were spinal or epidural only, spinal or epidural plus another medication, and other pain medication only. Women who received medications from any of the categories had about twice the risk of having delayed lactogenesis II ( 72 hours) compared to women who received no labor pain medication.[ 4 ]
Levels in milk
Maternal Levels. Nine women in the early postpartum period were given intravenous alfentanil 50 mcg initially and then 10 mcg as needed during tubal ligation surgery under general anesthesia. Colostrum was sampled prior to surgery at 4 and 28 hours after the last intraoperative dose. No postoperative doses were given. At 4 hours after the last dose, the average level of alfentanil in colostrum was 0.88 mcg/L and the highest measured level was 1.5 mcg/L. Alfentanil milk levels 28 hours after the last dose were about the same as presurgery (control) levels; however, average cumulative alfentanil dosage was not reported.[ 1 ] Using the highest measured alfentanil level in this study, an exclusively breastfed infant would receive an alfentanil dosage of 0.2 mcg/kg daily. Infant Levels. Relevant published information was not found as of the revision date.
Alternatives LactMed lists
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.