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Breastfeeding, Remicade, and infant vaccines

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  • Breastfeeding, Remicade, and infant vaccines

    From reading other posts it seems that while taking remicade it is safe to breastfeed. The nurse that administers my remicade told me that the baby can't get vaccines for the first 6 months if you are breastfeeding while taking remicade. I don't really understand this. If it doesn't pass through the breastmilk (after first 7 days), why would it matter about the baby receiving vaccines (I assume she meant live vaccines). Thanks.

  • #2

    I would suggest that you talk to the nurse and/or physician for further clarification as to why the infant should not be vaccinated for 6 months. I’m not sure why the nurse suggested this.

    I discussed your question with Dr. Hale. Because the Remicade causes you (the mom) to be immunocompromised, we think the greater concern is any exposure you might get from the infant if the infant receives a live vaccine. The Remicade you are taking is not expected to cause the infant to be immunocompromised.

    If you have any further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday-Friday from 8:00am-5:00pm, CST.

    Colleen Peace, BSN, RN
    TTUHSC, InfantRisk Center


    • #3
      I have active crohns disease and have recently been suffering from proctitis. My doctor just prescribed apriso at 1500 g a day (4pills). My daughter is 7 weeks old and I am concerned about the risks to her. Should I be concerned? My doctor believes that since this drug is released in the lower colon it is safer than other mesalamine drugs. I'm still worried. Do the benefits of breastfeeding outweigh the risks?


      • #4
        Hi, thanks for your post.

        It looks to me like Apriso carries just about the same breastfeeding risk as regular mesalamine. Both of them are fairly safe drugs to use. Mesalamine is meant to act locally on the colon and only about 20% makes it into the bloodstream. The baby gets 1-8% of your dose, but only 20% of THAT is absorbed by the baby. There have been some reports of watery diarrhea in babies exposed to mesalamine and that resolves quickly when the exposure is taken away.

        Despite its similar chemistry, mesalamine has never been associated with Reye syndrome.

        The benefits of breastfeeding (and properly treating your proctitis) far outweigh the risks from this medication.

        Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

        -James Abbey, MD