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Hello,
I am curious about your take on infliximab and breastfeeding. I understand that the RID of infliximab is 0.3-0.7%. I also understand that infliximab should have low bioavailability in the gut (given that it is given by infusion for that reason). I am curious, however, about the findings from the Fritzsche study (see link below). This was a case series that studied the presence of infliximab in breastfed infants. In one of their mother-child pairs, they found an infant infliximab level of 1700ng/mL (Fritzsche et al, Infliximab and Adalimumab Use During Breastfeeding). It is somewhat hard to figure out the timing of this serum measurement but it seems that this test was performed 38 weeks postpartum (the first test was performed at 34 weeks and the second test 4 weeks later), at which time I would imagine that infliximab levels from pregnancy would be undetectable. This appears to be the only case report of detectable serum levels in an infant that are attributable to breastfeeding, but I was hoping I could get your take on this. The paper muses about possible uptake via the Fc receptor in the infant gut.
On the advice of my gastroenterologist, I have been breastfeeding my baby. I understand also that you consider this medication to be safe, and with a very low RID. I'd be interested, however, to hear your take on this.
Sincerely,
Jess
I am curious about your take on infliximab and breastfeeding. I understand that the RID of infliximab is 0.3-0.7%. I also understand that infliximab should have low bioavailability in the gut (given that it is given by infusion for that reason). I am curious, however, about the findings from the Fritzsche study (see link below). This was a case series that studied the presence of infliximab in breastfed infants. In one of their mother-child pairs, they found an infant infliximab level of 1700ng/mL (Fritzsche et al, Infliximab and Adalimumab Use During Breastfeeding). It is somewhat hard to figure out the timing of this serum measurement but it seems that this test was performed 38 weeks postpartum (the first test was performed at 34 weeks and the second test 4 weeks later), at which time I would imagine that infliximab levels from pregnancy would be undetectable. This appears to be the only case report of detectable serum levels in an infant that are attributable to breastfeeding, but I was hoping I could get your take on this. The paper muses about possible uptake via the Fc receptor in the infant gut.
On the advice of my gastroenterologist, I have been breastfeeding my baby. I understand also that you consider this medication to be safe, and with a very low RID. I'd be interested, however, to hear your take on this.
Sincerely,
Jess
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