Humira

[Chrissycookies212]

Hello,

I see the last thread regarding Humira is from 12/2014 "no data". Has there been any new data published in the last 9 months regarding Humira vis a vis breastfeeding? I am due to start this med tomorrow or Wednesday and I'd like more information as my rheumatologist says the molecule is too big and doesn't pass into milk, while my daughter's ped says it necessarily does as it's an L3: "risk demonstrated" according to Dr Hale's book "Medications and Mother's Milk" (not sure of the pub date of her copy), but to go ahead if the benefits outweigh the risks. Is this accurate? If so, does L3 mean "demonstrated risk of passing into milk" or "demonstrated risk of harm to baby", as in babies have been harmed from drinking "Humira milk". I'd be more comfortable with the former, as I know Humira has a low oral bioavailability.

I am also a little concerned that her dr might withhold vaccinations as I've read that it's not recommended to give vaccines to babies born to moms who take Humira during pregnancy or who breastfeed until they are 6 months old or for 6 months after weaning, respectively. Are you aware if that recommendation is for all vaccines or only the live ones? Finally, would you consider Enbrel as a viable alternative, and is there anything relevant to know about this med? Any clarification you can add would be much appreciated

[Chrissycookies212]

Hi again,

I'm so sorry: I should have doubled-checked her info before posting. I see L3 means no published data, so no need to clarify! I assume your previous myriad answers about Humira will hold true for me unless you let me know that there has been new published data. Also, if you have anything to add about the vaccines, I'd appreciate it. Do you have any idea why she is under the impression that this medication does get into milk? Perhaps she doesn't recognize the difference between L2 and L3. I will discuss this with her again. Thanks!

[Sandra]

Chrissycookies212, thanks for posting,

Humira is still rated an L3-limited data-probably compatible. The amount transferred into breast milk is 0.12% of your dose. Monitor the infant for vomiting, weight gain, and frequent infections. Although the molecular weight of this medication is very large and the amount in breast milk 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. We believe it is probably safe to continue breastfeeding your infant since she is older and will be receiving less breast milk than say a newborn would, and as infants get older their kidneys and liver are more mature and better able to excrete medications. The safety of administering live or live-attenuated vaccines to infants exposed in utero is unknown. Risk and benefits should be considered prior to vaccinating with the live or live-attenuated vaccines. Your infant is older and was not exposed in utero so she should be able to receive her vaccines as scheduled, live or killed unless she becomes immunocompromised.

Enbrel is an L2-limited data-probably compatible. The amount transferred into breast milk is 0.07-0.2% of your dose. Monitor the infant for vomiting, fever and frequent infections. This medicine is also a biologic medication so above information would also apply to it.

I hope this helps. If you have any other Questions please call the InfantRisk Center at 806-352-2519. Thanks,

Sandra Lovato R.N.
InfantRisk Center

[Larmn123]

Hello- I am currently 33 almost 34 weeks pregnant and have to take humira due to ankylosing spondylitis. So I have been taking humira throughout pregnancy. I am trying to decide if I should breastfeed as I am going to need to continue to take humira once baby is born. Do you recommend breastfeeding while on humira? And can I breastfeed right after birth when I am still in the colostrum phase? Since the baby will be so small and I will have colorstrum is there the potential for the baby to be more affected by the humira?