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Effect of enoxaparin and nadroparin on lactation

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  • arvense
    started a topic Effect of enoxaparin and nadroparin on lactation

    Effect of enoxaparin and nadroparin on lactation

    A mother that I'm counseling has thrombophilia. She is pregnant and will receive treatment with enoxaparin or nadroparin. The treatment may also continue after birth. She has been advised that those anticoagulats may decrease milk production. Are there any grounds for this advice?

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    In breastfeeding enoxaparin is rated an L2-limited data-probably compatible. The molecular weight is large (2000-8000 daltons). "The size alone would largely preclude its entry into human milk at levels clinically relevant. Due to minimal oral bioavailability, any present in milk would not be orally absorbed by the infant. A similar compound, dalteparin, has been studied and milk levels are extremely low as well." (Medications and Mothers' Milk database, Thomas Hale PhD).

    We have no data on nadroparin, but it is an anticoagulant belonging to a class of drugs called low molecular weight heparins. It is very similar to enoxaparin. It has a molecular weight of 4300 daltons, so it would also have a difficult time entering breast milk.

    We recommend monitoring your infant for rare-bruising on the skin, blood in urine, vomit or stool, or petechiae.

    We do not have any data suggesting either could decrease milk supply.

    Sandra Lovato R.N.
    InfantRisk Center

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