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Cortisone Shot & Breastfeeding Toddler

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  • Cortisone Shot & Breastfeeding Toddler

    I have an almost 15 month old daughter who has no interest in weaning, and when I last saw my rheumatologist when she was about 8 months old he was trying to convince me to wean when she turned one and go back on Humira. I have no interest in forcing her to wean or going back on Humira even when she does.

    However, I am seeing him tomorrow and would like to be armed with as much information as possible on any impact on her via my milk from a single cortisone injection to my knee that I will be requesting.

    Any specific data or research references would be most appreciated!! I would just tell him I've weaned but I'm tired of being bullied by all of my doctors with their misinformation!

  • #2
    Dear MaitriMama,

    Adalimumab (Humira) is a recombinant humanized IgG1 monoclonal antibody specific for human tumor necrosis factor (TNF).TNF is implicated in the pain and destructive component of arthritis and other autoimmune syndromes. Although the molecular weight of this medication is very large and the amount in breastmilk is very low, there are no long term data concerning the safety of using immune modulating medications in breastfeeding mothers. Further there are current data that suggest that some IgG drugs do transfer into milk, and perhaps the breastfed infant. Therefore, some caution is recommended and each woman should understand the benefits and risk of using this type of medication in lactation.

    That being said, the infant will only receive approximately 0.12% of moms dose. In a study of two infants where the moms took adalimumab 40mg subcutaneous each week during lactation were followed until 14.5 and 15 months of age. No infant adverse reactions were found to be attributed to exposure of the drug in breast milk and both infants were reported to have met all developmental milestones.

    I am afraid without the specific name of the cortisone injection being used we would not be able to advise properly, when you find out what medicine they will be injecting please contact us at the Infant Risk Center at 806-352-2519.

    Hope this is helpful!!!

    Sandra Lovato R.N.
    InfantRisk Center