Getting Methotrexate injection for ectopic while breastfeeding

[malloryk93]

Hello,

I currently have an ectopic pregnancy that needs to be addressed. Tomorrow I will most likely be getting an injection of methotrexate. My issue is that I have been getting mixed information about wether breastfeeding after getting this injection is safe or not. The OB that will be giving me the injection has said that I should not breastfeed for 3 months after (the same time that you are not supposed to conceive after receiving the injection) but the nurse I have been working with said that their pharmacist said to her that newer studies show that it is safe after a very short time to continue breastfeeding. I would love to have this subject cleared up a bit for me, as my daughter is nowhere near ready to wean. She just turned 1.

[Sandra]

malloryk93,

"Pregnancy should be avoided if either partner is receiving methotrexate; during and for a minimum of three months after therapy for male patients, and during and for at least one ovulatory cycle after therapy for female patients." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).

"It is apparent that the concentration of methotrexate in human milk is minimal, although due to the toxicity of this agent and the unknown effects on rapidly developing neonatal gastrointestinal cells, it is probably wise to pump and discard the mother's milk for a minimum of 24 hours post dose if given as a single dose (e.g. 50 mg/m2 IM for ectopic pregnancy) or administered once weekly (e.g. for RA). The period in which the mother discards her milk may require extending (consider 4 days of interruption) if the dose used is quite high (>75mg) or if the dose is frequently administered (more than once weekly). Being on scheduled doses more than once a week is likely to be a situation where the mother should not breastfeed at all." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).


Sandra Lovato R.N.
InfantRisk Center