Is Desmopressin safe while breastfeeding?

Summary of use during breastfeeding

Desmopressin from a nasal spray is excreted in negligible amounts into milk and is poorly absorbed orally by the infant, so it appears acceptable to use during breastfeeding. There is no published experience with sublingual desmopressin during breastfeeding. Until more data become available, sublingual desmopressin should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

Effects on the breastfed infant

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

Effects on milk supply

Several cases have been reported of mothers with diabetes insipidus using desmopressin and breastfeeding their infants.[2-4] In one case, the mother discontinued nursing after 2 weeks because of a low milk supply, but this was not clearly drug related.[3] Lactation sometimes improves diabetes insipidus and reduces desmopressin requirements.[2,3]

Levels in milk

Maternal Levels. In a patient who was using intranasal desmopressin 10 mcg twice daily for diabetes insipidus, serum and milk levels of arginine vasopressin were measured after a dose.[1] Milk levels gradually increased from the background level of 1 ng/L to about 1.5 ng/L over the 4-hour observation period.

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