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I am currently breastfeeding my 2 year old before bed and occasionally overnight. My cholesterol has been creeping upwards for the last several years (family history), but I’ve been either pregnant or breastfeeding and trying to treat with diet and exercise. That no longer is working and my numbers are high enough that my primary Dr wants me to start a statin, likely Crestor, ASAP. She has advised to stop breastfeeding, but I’m wondering if considering that I’m only feeding at night and my daughter is 2, how concerned should I be about the possibility of medication transferring through my milk to her? Or is there another medication that has more data in it and would be better? We were planning on another pregnancy in the near future, so my doctor would really like to get my cholesterol down prior to that, knowing that I’d stop medication if/when that happens.
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Hi Amber,
You've unfortunately stumbled into a hot debate and a topic of our current research. Rosuvastatin has limited safety data, more than any other statin. We estimate less than 2% of an infant-sized dose is available to a fully breastfed infant via breastmilk. Typically, we consider anything less than 10% (sometimes 5%) a reasonable risk in a healthy infant. However, we have additional things to consider with statins like rosuvastatin. Largely, we don't know if it changes the nutritional content of breastmilk (like cholesterol or lipid levels). These concerns have led the FDA and clinicians to advise against breastfeeding while on a statin. Interestingly...we also need to find out how high cholesterol impacts breastmilk's nutritional content. There is plenty of research to be done!
You are correct that your toddler's risk will be lower than a fully-breastfed infant. Overall, my first advice would be to consider non-pharmacological interventions (like diet and exercise). The decision to breastfeed while on a statin should be shared between you, your provider, and your toddler's pediatrician. There are many factors at play!
Dr. Kaytlin Krutsch, PharmD
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