Pumping and discarding for 4 days after receiving methotrexate is our recommendation. Toddlers get much less milk per day in relation to their body weight as compared with infants and they are better able to tolerate incidental medication exposure. Given that you waited 17 days, it is highly unlikely that your baby will experience any complications.
Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519
Nichole Campbell, MSN, APRN, NP-C
InfantRisk Center
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Breastfeeding in ectopic pregnancy
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Hi, I received single shot of methotrexate injection on oct 26, 2023 for ectopic pregnancy with hcg level 1770 (not sure about the mg given to me). My Hcl level dropped to 35 on day 7. I have 20 months old toddler and I nurse him thrice for comfort to make him sleep. My Gynecologist told me to avoid breastfeeding for 2 weeks and my pediatrician told me to avoid for 3 weeks. But I was not informed to keep extracting the milk before I resume breast feeding. I extracted the milk only once after 36 hrs after the shot using milk extracter. Later , I just hand expressed the milk for 10 minutes once at night time (3 days once) just to maintain the milk supply during the withhold period and I could extract maximum of 10 ml each time. As per my pediatrician advise, I was waiting to complete 21 days to resume breast feeding. But on day 17 (Nov 12) due to unavoidable situation, I breastfed my kid and I continued to feed him. When I searched about , what precaution to be taken before resuming breast feeding after methotrexate injection, I came to know that I have to extract the milk before resuming breastfeeding. My concern is I waited so long to feed my kid back , but I resumed feeding without properly extracting much milk. Is that an issue to my kid? Thanks for your reply in advance.
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I was just given methotrexate injection intramuscular 93mg.. how long do I need to wait to breastfeed? My daughter is 22 months old, 38 lbs, and nurses pretty frequently still.
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Dschex,
We recommended pumping and dumping for 4 days for a single large dose of Methotrexate of 100mg.
Sandra Lovato R.N.
InfantRisk Center
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I am currently breastfeeding my 21 month old (30 pounds) a few times a day. My dr thinks I may have ectopic pregnancy and may need a shot of Methotrexate (100 units?) tomorrow. When can I resume breastfeeding? I haven’t pumped in 8 months because he wasn’t nursing as much. Thank you.
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I received 4 dosages of methotrexate and I noticed everyone pumped and dumped I waited about 3 weeks to breastfeed but I did not pump and dump my child is 2 and I don't know what precautions I should be taking I found no research of what the risks are to the child after breastfeeding should I take him to the doctors I don't know what to do
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Kenka,
Depending on your dose we would recommend pumping and dumping for 1 day if you received a dose of 50mg or less and 4 days for a dose greater than 50mg. Your infant is older and not very much of this medication transfers into milk, only 0.13-0.95% of yours dose, so hopefully she did not get much of the medication, but again depending on how much you received wait that amount of time now.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519Last edited by admin; 02-02-2017, 09:23 AM.
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I just had a dose of methotrexate yesterday for ectopic pregnancy and i guess I was so tired I completely forgot to ask if I could continue breastfeeding, it didn't cross my mind. So I got home and breastfed just like any other night but I woke up around 5am freaking out because I didn't know if I could breastfeed. My daughter is 18 months old. What do I do??
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sandra tnx, hm, it seemed to me like my dosage was high. two times 92 mg, it is almost 200 mg...i am scared to continue with bf. i will wait at least one month to continue amd hope so that baby will likebit again.
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Tanja,
With the dose you received and the fact you received it only twice we would have advised to wait 4 days after last injection to breastfeed so you should be ok to resume breastfeeding now.
Sandra Lovato R.N.
InfantRisk Center
806-352-2519
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hi, can you please advise me when i could start breastfeesding my 9 months old baby again? i had an ectopic pregnancy i got 2 shots of methotrexate. first one was on July 6th and second one on July 14th. Both times the dosage was according to my height and weight 92 mg, divided in two actually, one injection 50 other one 42...i dont know why they didnt give it at once....i will pump and dump my milk as much as i can and i gues it is best to do it as long as possible...
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Me again, my first dose of methotrexate 100mg didn't work last week, so have another dose for tomorrow. What do I do now with regards to breastfeeding. Pump and dump like before for 4 days? Thank you.
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Hi, thanks for your post.
Yes, 4 days is still our recommendation. In your case, the margin of error is even greater with an older child. Toddlers get much less milk per day in relation to their body weight as compared with infants, and they are better able to tolerate incidental medication exposure.
Please call us at the InfantRisk Center if this has not completely answered your question. (806)352-2519
-James Abbey, MD
and
-Thomas W. Hale, Ph.D.
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