Kate your wrote,

"Misoprostol like most drugs is dangerous when used incorrectly and, like all
drugs, has potential side effects."

Your are right but I also think we need to understand that some drugs even
used correctly can create problems in certain people. The truth is that
misoprostol (Cytotec) is not being used correctly according to the
manufacturer.  This drug was never approved by the FDA for use in induction
and therefore has never gone through the studies that might make us aware of
potential problems.  I find it pretty amazing that in this litigious society
that we live in, that OBs and midwifes are so willing to use a drug that's
intended purpose was as an ulcer medication.

While we do not have any documented effects on lactation, we do know
logically that it will effect the lactation of some of the women who have an
adverse reaction to it. She may have alot of separation from her baby because
of bleeding or a hysterectomy.  If she has a retained placenta fragment, we
would see a milk supply problem.  Sheehan's syndrome could be another
possibility. The baby might not be in good condition either to breastfeed or
breastfeed well.  We do know that in the one study from Brazil misoprostol
seemed to have a higher than normal effect of infant facial paralysis.  Was
this because the women who used this drug in an unsuccessful abortion attempt
used it in the 9th week of their pregnancy?  Or is this a possibility for a
full term infant when used in an induction?  Facial paralysis would certainly
effect breastfeeding.

We don't have the studies on this drug in regard to induction because they
were never done because this was not the intended use for this drug.  We as,
lactation consultants, may have seen effects of this drug but not known it
was related to the use of misoprostol/cytotec.  Valerie W. McClain, IBCLC

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