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Breastfeeding with Humira

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  • Breastfeeding with Humira

    I tried calling the center multiple times today and could not get through. I hope to receive a response quickly as I am due in 5 days.

    I was diagnosed with moderate to severe Crohn's Disease in 2005. I had resection surgery 9 months later and have maintained remission ever since due to Azathioprine and Humira. I have been on 100mg of Azathioprine and 40mg injection of Humira every other week. My gastroenterologist advised me to take a final injection of Humira when I was 32 weeks pregnant as after that is when the baby is soaking up my antibodies at a very high rate. I should continue Humira a few days after giving birth. The plan is to take me off of Azathioprine after I give birth because I have been doing very well for a few years now. I have stayed on the Azathioprine throughout the pregnancy as a kind of maintenance while I have ceased the Humira. My doctor advised that breastfeeding while on Azathioprine is not recommended so it is worthwhile to stop it after giving birth. I am now 39 weeks pregnant and stopped taking the Azathioprine to give it a few days to flush out of my system before giving birth and beginning to breastfeed.

    When I met with the pediatrician I told her about my medications because I was informed that my taking these medications while pregnant could affect the baby's immunization schedule. She was much more concerned with my intentions to breastfeed while taking Humira. She informed me that there have not been any studies done on the long-term effects of Humira in breastfed babies. Her words were, "Why take a risk with an unknown when you know formula is perfectly fine?" Even though the gastroenterologist and Ob/Gyn have told me that in theory taking Humira and breastfeeding should be fine, I am frozen with fear by the pediatrician's words. Therefore, up until this late stage I am conflicted on how to proceed. My plan thus far has been to stop Azathioprine a few days before my due date so I could breastfeed for at least a few days. Then when I continued Humira, I would switch to formula. After reviewing another thread on this forum about mature milk and the passage of Humira into the milk, I am again on the fence and thinking of continuing to breastfeed while taking Humira.

    My question boils down to this: do the benefits of breastfeeding outweigh the potential risks and unknowns of Humira? Or is the guaranteed safety of formula the best way to proceed? I am also on 20mg of Fluoxetine for depression. My doctor will switch me to a better anti-depressant if I decide to breastfeed longer than two weeks.

    Thank you for reading and I await your response.

  • #2
    I've been on Humira and breastfeeding for several years, and we've had no issues. I'm comfortable with it because Humira has a huge molecular weight- much too large to cross over the blood/breast barrier and affect milk. Secondly, it's not bioavailable orally. That's why you have to inject it, because it breaks down when it's digested.

    I disagree that formula is "perfectly fine" and has "guaranteed safety", though. I've nursed two children on Humira, and they're both fine.