Entocort and breastfeeding

[killerzoey]

Entocort and breastfeeding ***UPDATED***

Update:

I finally found information on the website of the famous Dr. Hale, expert on breastfeeding and medications.

A physician had posted a question about oral Entocort for Crohn's and Dr. Hale wrote: "...It's virtually unabsorbed, only works in gut. Only 10% absorbed, and most of this is sequestered in the liver. I would bet none reaches the milk compartment. " He said it's ok!

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Hi all

Today I phoned my doctor and said I'm ready to try some medication for the pain. He had me come pick up Entocort samples - 16 days worth.

I knew that Entocort is a steroid and that the steroid Prednisone was considered moderately safe while breastfeeding. My logic went "Well, if Entocort does not circulate systemically to the degree that Prednisone does (rather 90% goes straight to the intestines), then Entocort must be even safer."

But I looked online and there was just the standard line of "we don't know but we suspect that it is secreted into breastmilk and so don't breastfeed on it".

The thing is, they say this about everything to cover themselves, as well they should. There are many cases when drugs are proven safe while breastfeeding because women go ahead and do it (I guess) creating empirical data that it's safe. It turns out that the breasts filter most drugs quite nicely and that the amount baby gets isn't scary. I suspect Prednisone would still be in the complete no-no category if it were new.

I very much want to take the Entocort (rather than Prednisone) and am trying to decide if this is one of those situations where it's just categorically off limits because it is a new drug and there hasn't been the time for its safety to become known. (I know budenoside isn't new but typically it's inhaled or squirted, I believe, which they consider low risk for breastmilk).

I don't expect anyone can help me sort this out...but throwing it out there just in case.

My tot is really into nursing. She's old enough to wean, but she's emotionally still very sustained by it.

Thanks for listening...

 

[Creepy Lurker]

Well, according to wikipedia (sorry) both drugs are classed as 'Pregnancy Category C'

Cat C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

 

[Kev]

Hi KZ.. I think the subject is too fraught with peril to chance to any info your garner here... and I wouldn't trust an online source like wikipedia regardless of whether the info there was pro or con. I would run this by your doctor, (at the very least) or your OB/GYN or pediatrician... The health benefits of breast milk are widely documented, and there are distinct advantages/benefits to both mother and child. Can you pump and store your milk? Are there other meds you can take? When do you need to start these meds? if your child is close to weaning anyway, then maybe switching from breast milk to formula is your ultimate best choice now.
Just because you switch from breast to bottle doesn't mean you have to lose the closeness, proximity of nursing.. If you tackle it the right way, this doesn't have to be a 'disruption', merely an evolution.. a natural change both of you can live with.

 

[old hat]

The active ingredient in Entocort is carried in human milk (no maybe about it) which is why the Prometheus Laboratories Inc, the manufacturer, says that pregnant women should not take it.

The actual amount secreted into the breat milk isn't clear and neither is the effect (if any) this would have on the child. The manufacturer is (I suspect) erring on the die of caution because of the enormous, potential liability if it turn out that the stuff isn't safe for breastfeedng women to take. However, there are very real concerns involved and you should definitely talk to your doctor about the possible benefits and risks fo his treatment before starting it.

 

[killerzoey]

Thanks, all. Yeah, I decided not to take the Entocort. I was just pouty because I sensed possible relief in sight and now I'm back to the drawing board.

I made an appointment for next week back home. I've been traveling for nearly 2 months and am glad to be heading home where I can start (hopefully) some sort of treatment. The GI doc I've been seeing here has been wonderful for the diagnosis but he was hesitant to even give me the Entocort, wanting rather to have me see someone back home anyway. So that's what I'll do.

This aching pain is driving me nuts.