Breastfeeding whilst taking imura & prednisolone

[Kimmy D]

Hi all,

Wanting some advise on breastfeeding whilst taking Imuran and Prednisolone.

I'm currently 23weeks pregnant and have continued to take both meds throughout my pregnancy (closely monitored by OB & GI) but my GI has told me that breastfeeding is totally up to me. He has explained that it does cross over into breastmilk but there was no evidence that it caused any harm to the baby. He did say that a lot mums choose not to though.................

I'm leaning towards not breastfeeding because of the unknown, and the fact that I have to have blood test done every 3month to make sure the meds aren't effecting other organs etc not to mention the bone scans to ensure I have developed osteoporosis. I'm just worried what these will do to such a little body........

Would love to hear your thought and experiences.

Thank you!

 

[Jennifer]

I honestly have no experience here but I'm gonna tag Judith to see if she has any info on these meds and breastfeeding. Keep us posted on how you're doing.

 

[Judith]

Kimmy D,
Congratulations on your pregnancy!

Breast feeding is important to baby. Not only does it cement mother-child bonding but baby will obtain nutrients and Immunity through your milk. Newborns have an underdeveloped immune system so whenever possible it is a good idea to breast feed so your little one can receive immunity toward the microbes you have been exposed to (and have mounted an immune response).

Prednisolone is secreted in breast milk. However, the greatest amount of drug is secreted 1-4 hours after taking the medication. Most physicians simply suggest not breast feeding for about 4 hours after taking Prednisolone.

Imuran is a Pregnancy Category D medication (generally not advised to take during pregnancy) or during breast feeding BUT the benefit vs risk needs to be assessed. The literature points out that "Small Quantities" of the drug are transferred through the placenta and breast milk, but as you stated, the effects on a small body are often more pronounced than in adults. However, many medications that can be risky to take during pregnancy will be taken for patients with severe forms of Crohn's disease because the risk of having a flare during pregnancy along with associated complications such as malnutrition can be of greater risk to the developing fetus than the risk from the drug.

Here is a link from the FDA talking about Imuran in Pregnancy / Nursing (pages 4-6).
Imuran in pregnancy/nursing p. 4-6

Breast feeding is important but it is important to keep yourself healthy as well. Even if you are not convinced from your own health standpoint, consider how many nutrients are needed to make high quality milk for your baby. So, if you have severe Crohn's disease and need the medication getting off of them may not be the best idea.

One option that may help you out would be milk from another mother. Some women produce *so much* milk - far more than their baby can consume - that they donate it to other mothers / babies. If you are willing to do so, recieving donated milk can help baby get the nutrients he/she needs and allow you to remain on the medications required to keep your Crohn's under control.

Here are some milk donation companies. Your OB/GYN should be able to set up delivery of milk if you wish to utilize this resource.

http://www.nationalmilkbank.org

https://www.hmbana.org

http://www.prolacta.com

I hope it helps, please keep us updated about how you both are doing and Congratulations again on the new family member.