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Breast-feeding after transplantation

Lookup NU author(s): Emeritus Professor John Davison

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Abstract

Transplantation affords recipients the potential for a full life and, for some, parenthood. Female transplant recipients must continue to take immunosuppression during pregnancy and breast-feeding. This article reviews case and series reports regarding breast-feeding in those taking transplant medications. Avoidance of breast-feeding has been the customary advice because of the potential adverse effects of immunosuppressive exposure on the infant. Subsequent studies have demonstrated that not all medication exposure translates to risk for the infant, that the exposure in utero is greater than via breast milk and that no lingering effects due to breast-feeding have been found to date in infants who were breast-fed while their mothers were taking prednisone, azathioprine, cyclosporine, and/or tacrolimus. Thus, except for those medications where clinical information is inadequate (mycophenolic acid products, sirolimus, everolimus, and belatacept), the recommendation for transplant recipients regarding breastfeeding has evolved into one that is cautiously optimistic. (C) 2014 Elsevier Ltd. All rights reserved.

Publication metadata

Author(s): Constantinescu S, Pai A, Coscia LA, Davison JM, Moritz MJ, Armenti VT

Publication type: Article

Publication status: Published

Journal: Best Practice & Research Clinical Obstetrics & Gynaecology

Year: 2014

Volume: 28

Issue: 8

Pages: 1163-1173

Print publication date: 01/11/2014

ISSN (print): 1521-6934

ISSN (electronic): 1532-1932

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.bpobgyn.2014.09.001

DOI: 10.1016/j.bpobgyn.2014.09.001

PubMed id: 25271063

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