Dinoprostone use while Breastfeeding
Drugs containing Dinoprostone: Cervidil, Prepidil, Prostin E2
Medically reviewed by Drugs.com. Last updated on Aug 7, 2018.
Dinoprostone Levels and Effects while Breastfeeding
Summary of Use during Lactation
Dinoprostone (prostaglandin E2) has not been measured in human milk after exogenous administration, but it is a normal component of breastmilk in small amounts where it may help protect the infant's gastrointestinal tract.
Use of vaginal dinoprostone to induce labor appears to have a negative effect on breastfeeding. Given orally in the first few days postpartum, dinoprostone can suppress lactation. Whether postpartum vaginal or endocervical administration suppresses lactation is not known, but it should probably not be used postpartum in mothers who wish to breastfeed. By one month postpartum, the drug appears not to suppress lactation.
Maternal Levels. Milk levels of dinoprostone have not been measured after exogenous administration to humans. However, it is a normal component of breastmilk, where it may play a role in protecting the infant's gastrointestinal tract. Normal concentrations in milk vary widely over a range up to about 500 ng/L, but appear to be similar to the maternal plasma concentrations.
Vaginal or endocervical administration of dinoprostone for induction of labor produces maternal serum concentrations about double the normal levels, so milk concentrations are likely to be comparably higher following exogenous administration.
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
A retrospective cohort study of birth records in Cardiff, Wales, UK found that the use of vaginal prostaglandins for the induction of labor resulted in an 11% decrease in the likelihood that mothers would be breastfeeding at 48 hours postpartum. The subgroup of first-time mothers had a 15% decrease.
A nonrandomized prospective study compared women who had spontaneous deliveries with those who had elective induction using dinoprostone vaginal gel. At hospital discharge, exclusive breastfeeding rates were similar between the two groups (88% and 89%). However, at 1 and 3 months postpartum, exclusive breastfeeding rates were significantly lower in mothers who had dinoprostone induction than in those who delivered spontaneously. Exclusive breastfeeding rates were 54% and 85% at 1 month and 46% and 59% at 3 months postpartum, respectively. Rates of supplemental and exclusive formula feeding were higher in the induced mothers at both time points also.
Dinoprostone has been used investigationally to inhibit postpartum lactation and engorgement by reducing serum prolactin concentrations. The effect on prolactin levels, engorgement and lactation appears to be dose and duration related. Oral dosages of 3 mg daily for 4 days or 0.5 mg three times daily were ineffective, whereas oral dosages of 8 to 12 mg over 24 to 30 hours were effective. These effects seem to be limited to the first few days postpartum; dinoprostone had no effect on serum prolactin or milk production when given to women 30 days postpartum. Compared to oral bromocriptine 2.5 mg every 12 hours for 14 days, dinoprostone 12 mg orally in divided doses over 30 hours was as effective as bromocriptine, but resulted in less rebound breast tenderness.
1. Lucas A, Mitchell MD. Prostaglandins in human milk. Arch Dis Child. 1980;55:950-2. PMID: 7458394
2. Neu J, Wu-Wang CY, Measel CP, Gimotty P. Prostaglandin concentrations in human milk. Am J Clin Nutr. 1988;47:649-52. PMID: 3162635
3. Hawkes JS, Bryan DL, James MJ, Gibson RA. Cytokines (Il-1beta, Il-6, TNF-alpha, TGF-beta1, and TGF-beta2) and prostaglandin E2 in human milk during the first three months postpartum. Pediatr Res. 1999;46:194-9. PMID: 10447115
4. Le Deist F, De Saint-Basile G, Angeles-Cano E, Griscelli C. Prostaglandin E2 and plasminogen activators in human milk and their secretion by milk macrophages. Am J Reprod Immunol Microbiol. 1986;11:6-10. PMID: 3461715
5. Shimizu T, Yamashiro Y, Yabuta K. Prostaglandin E1, E2, and F2 alpha in human milk and plasma. Biol Neonate. 1992;61:222-5. PMID: 1610950
6. Alzina V, Puig M, de Echaniz L et al. Prostaglandins in human milk. Biol Neonate. 1986;50:200-4. PMID: 3465374
7. Reid B, Smith H, Friedman Z. Prostaglandin in human milk. Pediatrics. 1980;66:870-2. PMID: 7454478
8. Goharkhay N, Stanczyk FZ, Gentzschein E, Wing DA. Plasma prostaglandin E(2) metabolite levels during labor induction with a sustained-release prostaglandin E(2) vaginal insert. J Soc Gynecol Investig. 2000;7:338-42. PMID: 11111068
9. Siqueira M, Neves J, Arteaga M et al. [Plasma prostaglandin E2 in pregnant women undergoing labor induction with endocervical gel application]. Rev Esp Med Nucl. 1999;18:268-71. PMID: 10481108
10. Jordan S, Emery S, Watkins A et al. Associations of drugs routinely given in labour with breastfeeding at 48 hours: Analysis of the Cardiff births survey. BJOG. 2009;116:1622-32. PMID: 19735379
11. Zanardo V, Bertin M, Sansone L et al. The adaptive psychological changes of elective induction of labor in breastfeeding women. Early Hum Dev. 2016;104:13-6. PMID: 27914274
12. Caminiti F, De Murtas M, Parodo G et al. Decrease in human plasma prolactin levels by oral prostaglandin E2 in early puerperium. J Endocrinol. 1980;87:333-7. PMID: 7452120
13. Beric B, Mitreski A, Kuzmancev O et al. [Inhibition of initial puerperal and postpartum lactation using oral prostaglandin E2 (dinoprostone)]. Med Pregl. 1992;45:421-6. PMID: 1344441
14. England MJ, Tjallinks A, Hofmeyr J, Harber J. Suppression of lactation. A comparison of bromocriptine and prostaglandin E2. J Reprod Med. 1988;33:630-2. PMID: 3172062
15. Nasi A, de Murtas M, Parodo G, Caminiti F. Inhibition of lactation by prostaglandin E2. Obstet Gynecol Surv. 1979;35:619-20. PMID: 7413116
16. Grunberger W. [Postpartum uterus involution and lactation levels in randomized comparison between prostin E2 tablets and methergine dragees]. Gynakol Rundsch. 1983;23:100-7. PMID: 6347832
17. Tulandi T, Gelfand MM, Maiolo LM. Effect of prostaglandin E2 on puerperal breast discomfort and prolactin secretion. J Reprod Med. 1985;30:176-8. PMID: 3858547
CAS Registry Number
LactMed Record Number
Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More about dinoprostone topical
- Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
- En Español
- 7 Reviews
- Drug class: uterotonic agents
- Dinoprostone topical
- Dinoprostone Cervical Gel
- Dinoprostone Vaginal Inserts
- Dinoprostone Vaginal Suppositories
- Dinoprostone Vaginal (Advanced Reading)