Presently we have a mother of a former 26 week preemie who is now 4 weeks old. She has received an injection into her eye of Avastin last evening. According to your book providing breast milk is contraindicated. The mother has informed me that the retinal specialist uses this medication in babies. Thoughts on if we need to hold off on giving the baby her milk? I am going to speak to the neonatologist as well as the retinal specialist.
Actually I don't think your impression of the details in my book are correct. Below is a paragraph from my book.
I actually think when used intravitreally in the mom, its probably safe to use. Its largely excluded from the milk compartment.
Tom Hale PhD.
Bevacizumab is a recombinant humanized antibody that binds all forms of vascular endothelial growth factor (VEGF). It has indications for the treatment of metastatic colorectal cancer, breast cancer, glioblastoma, and other forms of cancer. Recently, a number of reports have described the off-label use of intravitreally injected bevacizumab for the treatment of macular degeneration. It has an approximate molecular weight of 149 kDaltons. While we have no reports on its use in breastfeeding mothers, size alone would largely exclude it from the milk compartment. When used intravitreally, the dose (1.25 mg) is much lower than via systemic administration (5-10 mg/kg), and it is largely sequestered in the eye, thus plasma levels (and milk) would be be exceedingly low. The intravitreal use of this drug is probably compatible with breastfeeding. The systemic use of this drug would not be compatible with breastfeeding.
Thank you so much for your reply. After reading what you included you are right I did "misread" this.
I am so glad you responded!!
Thank you again,
Posting for a friend. Would the "systemic use of this drug would not be compatible with breastfeeding" mean....?? Can you explain briefly intravitreally vs systemic?
She has to take immune boosting drugs for cancer and apparently has to wean 8 month old. Just trying to find out more information for her.
Intravitreally means applied to the eye and systemic would be taken orally (by mouth). Please call the InfantRisk Center at (806)352-2519 if you have any further questions.
Maria Milla, MD