Is Butalbital safe while breastfeeding?

Summary of use during breastfeeding

Butalbital in breastmilk has caused poor feeding and vomiting in one infant. Other agents are preferred, especially while nursing a newborn or preterm infant. If butalbital is used, monitor the infant for sedation, poor feeding and poor weight gain.

Effects on the breastfed infant

The mother of a newborn took a product containing acetaminophen 325 mg, butalbital 50 mg, and caffeine 40 mg every 6 hours for 24 hours for a spinal headache, with the last dose a day prior to presentation at the emergency department. Her 7-day-old infant had a history of 1 to 2 days of poor feeding, lethargy and vomiting. The infant was somnolent, lethargic, and demonstrating diminished reflexes. The urine was qualitatively positive for barbiturate and had also had 1 mg/L of caffeine 15 hours after hospital admission. The infant's symptoms resolved within 24 hours. The symptoms were probably caused by butalbital.[1]

Effects on milk supply

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

Levels in milk

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

Infant Levels. A 7-day-old breastfed infant's urine was qualitatively positive for barbiturate after his mother took a combination of butalbital 50 mg with acetaminophen 325 mg and caffeine 50 mg every 6 hours for 24 hours.[1]