breastfeeding on biologic drugs

New moms may have many concerns about breastfeeding their newborns — Will the baby latch? Will I produce enough milk? Will I ever sleep again? Women with inflammatory bowel disease, however, have one more important concern: Is my medication safe for breastfeeding? Many women are more than willing to stop taking their meds (and risk disease flares) in order to protect their babies.

But according to new research published in the journal Gastroenterology, breastfeeding moms with IBD don’t need to worry about the safety of their biologic drugs.

“I think the takeaway is that these biologic medications are low risk in breastfeeding,” Rebecca Matro, MD, assistant professor medicine at Oregon Health & Science University, told CreakyJoints. “The important thing is that mothers feel comfortable staying on these important medications to control their IBD, because discontinuation of the medications can lead to disease flares, which will have a greater impact on their ability to care for their children.”

Dr. Matro and colleagues studied whether biologic drugs could be detected in the breast milk of more than 70 patients with IBD. The researchers went on to study the development of the patients’ babies.

What they found: There were low concentrations of such biologic drugs as adalimumab, certolizumab, infliximab, natalizumab, and ustekinumab in the breast milk. But reassuringly, infection rates and certain developmental milestones after a year were similar in babies who were breastfed and in those who were not, the researchers found. “Maternal use of biologic therapy appears compatible with breastfeeding,” according to the study authors.

“Expectant and new mothers understandably have concerns about the safety and effect of medications they are taking for inflammatory bowel disease on their nursing infants,” Dr. Matro told MedPage Today. “This study can provide reassurance to them and their gastroenterologists that while biologics are detected in very small amounts in breast milk, infants suffer no adverse outcomes.”

In a recent post on her blog Chronically Jess, Crohn’s disease patient Jessica Caron offered tips based on nursing her children while taking biologics.

“My clinician and I spent a lot of time talking about my disease before I became pregnant,” Caron wrote. “I spent even more time personally reflecting on my body, the disease, and my goals for my future little ones. Ultimately, we both agreed that untreated disease during pregnancy and breastfeeding would be far more harmful than treating the disease effectively might be.”

Even after Caron and her doctor had gotten on the same page, however, she found that many people, including a nurse, tried to change her mind. This required refining an elevator speech.

“Understanding the facts of your treatment course, and being able to explain them to others is helpful,” she advises.

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