Divigel | Estradiol Gel while Breastfeeding

What is Divigel | Estradiol Gel used for?

Is Divigel | Estradiol Gel usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?

Estradiol while Breastfeeding

CAS Number: 50-28-2

A natural Estrogen that is marketed for oral, injection and topical administration (skin and vaginal).On the chemical form of valerate, it is used in association with a progestin as a combined birth-control compound (e.g. Estradiol + Dienogest) Estradiol is excreted into breast milk in clinically non-significant amount (Nilson 1978) and no problems have been observed in infants whose mothers were treated (Pinheiro 2016). Plasma levels of these infants were undetectable or very low (Pinheiro 2016). After administration in the form of transdermal patches milk levels have been undetectable (Pinheiro 2016, Perheentupa 2004). Despite these data, an older publication associated the use of transdermal estradiol with a case of jaundice and poor weight gain (Ball 1999).There is greater passage to milk when the administration is vaginal. There is evidence (albeit inconsistent) that estrogen-containing pills may decrease milk production, especially during the first few weeks postpartumThey may reduce the protein content of the milk. No problems have been observed in infants whose mothers were treated, except some cases of transient gynecomastia in infants whose mothers were receiving a higher dose than usual. Estrogen exposure in childhood or adolescence, does not influence the subsequent production of milk. The American Academy of Pediatrics states that this medication is usually compatible with breastfeeding.

Estradiol while Breastfeeding

CAS Number: 50-28-2

Limited information on the use of estradiol during breastfeeding indicates that the route of administration and dosage form have influences on the amount transferred into breastmilk. Vaginal administration results in measurable amounts in milk, but transdermal patches do not. Maternal doses of up to 200 mcg daily transdermally do not increase estradiol or estriol in breastfed infants or cause any adverse effects in breastfed infants. Vaginal administration results in unpredictable peak times for estradiol in breastmilk, so timing of the dose with respect to breastfeeding is probably not useful. A case report of inadequate milk production and inadequate infant weight gain was possibly caused by transdermal estradiol initiated on the first day postpartum, but 2 small studies found no such effect when the drug was initiated after lactation was well established.

What should I do if I am breastfeeding mother and I am already exposed to Divigel | Estradiol Gel?

I am nursing mother and my doctor has suggested me to use Divigel | Estradiol Gel, is it safe?

If I am using Divigel | Estradiol Gel, will my baby need extra monitoring?

Who can I talk to if I have questions about usage of Divigel | Estradiol Gel in breastfeeding?