Can you take terbutaline while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Maternal use of oral or inhaled terbutaline is unlikely to affect a breastfed infant. The authors of several reviews and expert guidelines agree that use of inhaled bronchodilators is acceptable during breastfeeding because of the low bioavailability and maternal serum levels after use. Terbutaline use as a tocolytic agent might decrease the duration of breastfeeding.
Quoted from Terbutaline — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised July 15, 2024.
How much terbutaline gets into breastmilk
Maternal Levels. With long-term maternal intake of 2.5 or 5 mg three times daily orally, milk terbutaline levels ranged from 2.5 to 4 mcg/L at various times during the dosing interval. There was little fluctuation of milk levels. The average dose that an exclusively breastfed infant would receive based on these patients is 1.4% (range 0.7 to 2.2%) of the maternal weight-adjusted dose.
Infant Levels. Serum levels were undetectable (<0.1 mcg/L) in one 8-week-old exclusively breastfed infant whose mother was taking oral terbutaline 5 mg three times daily.
What has been seen in breastfed infants
Two papers have reported a total of 4 infants aged 3 to 8 weeks who were breastfed during maternal use of oral terbutaline 2.5 or 5 mg three times daily. None of the infants had any signs of sympathetic stimulation and all were developing normally. These cases were also summarized in a third publication.
Effects on milk supply
A small retrospective survey from Serbia found that mothers who received a beta agonist pharmacologically similar to terbutaline (fenoterol or hexoprenaline) as a tocolytic breastfed for a shorter period of time than those who received no tocolytic (4.5 vs 9.5 months). It is not known if terbutaline has a similar effect.
A study in an Australian hospital compared breastfeeding outcomes in women who received a cesarean section during 2 time periods. During the first time period women did not receive terbutaline before a category one or two cesarean section (n = 423). In the second period, all women receiving a category one or two cesarean section received terbutaline 250 mcg subcutaneously as a tocolytic agent unless there was a contraindication at the time a decision was made to perform a cesarean section (n = 253). The breastfeeding rates at the time of discharge were 95% in the first period and 99% in the second period. The difference was statistically significant.
Frequently asked questions
Can you take terbutaline while breastfeeding?
Maternal use of oral or inhaled terbutaline is unlikely to affect a breastfed infant. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
Does terbutaline pass into breastmilk?
LactMed's measured drug levels for terbutaline are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking terbutaline?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on terbutaline
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.