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It has been harder than I thought to completely stop nursing my 18 month old. We are down to night time only and I cut the sessions very short. I have been taking the herb sage to stop milk supply since the doctor will not prescribe the medication to stop it. I have heard it was moderately safe to continue nursing , but my doctors and family don't feel comfortable with that since there isn't any data and want me to be completely weaned. Beside the molecular weight being so large could you give me more info. Does it cross the blood brain barrier, etc. I plan to start my first infusion tomorrow and I am not yet fully weaned.
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Dear amejiamoore,
Abatacept (Orencia) is a selective T cell costimulation modulator. T lymphocytes are infection fighting cells in the immune system. Abatacept decreases the action of T lymphocytes thereby suppressing inflammation that causes the joint symptoms in RA. Besides the large molecular weight decreasing the ability of the medication to enter breast milk, abatacept also has minimal oral bioavailability which means that even if there was some of the drug in your breast milk, the child would not be able to absorb much, if any, of the drug. That is the reason abatacept has to be given IV instead of by mouth because the drug has difficulty being absorbed by that route. With both large molecular weight and minimal oral bioavailability, clinical effects in the breastfed infant would not be expected. Another factor in your child's favor is he is 18 months old. His body is able to process medications well and the amount of milk he ingests at this age is small which would further decrease his exposure to abatacept. If you have further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday through Friday, 8 to 5, Central Time.
Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center
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