IV Push Methotrexate and Breastfeeding

[stacy1202]

I was recently treated with two rounds of Methotrexate for Gestational Trophoblastic Neoplasia. The two cycles began every 14 days and I was given 25mg through an IV push for 5 days in a row during each cycle. So I received a total of ten 25mg doses via IV in a 28 day period. My last dose was 14 days ago and I'm wondering when it might be safe to breastfeed my 4 month old again. My oncologist had me do a methotrexate blood level lab draw today but I have not yet received those results and am not sure of how good of an indicator that will actually be on safety in my breast milk.

Thanks for your expertise on this situation.

[admin-james]

Hi, thanks for your post.

Levels of methotrexate in the blood and the milk maintain a constant equilibrium; when blood levels fall, milk levels fall proportionately. Our research indicates that 4 days from your last dose is sufficient time to wait before breastfeeding, no matter how much you got before that point. If your blood level was drawn after that time, I am expecting it to come back as negligible.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD