Breastfeeding, Mesalamine, and Reye's Syndrome
Sat, April 24, 2010 12:16 PM
Hi,
I'm 30 weeks pregnant for the first
time, have CD, and would really like to breastfeed. I've been on Pentasa
(4g/day) for a couple of years now to keep the CD under control. I've been talking with my GI and
future pediatrician about breastfeeding on Pentasa, but they are concerned
about the possibility of Reye's syndrome if our baby gets a viral infection,
because mesalamine is a 5-ASA. In other words, mesalamine is chemically very
similar to aspirin, which you are definitely not supposed to give to babies.
Has anyone else dealt with this concern? For those of you who have breastfed
while taking mesalamine, what did your doctors say about the possibility of
Reye's syndrome? Or has anyone changed medications from mesalamine to something
else in order to breastfeed, and if so, which medication?
Thank you SO much in advance for your help!
Joined Apr 24, 2010
Fri, May 07, 2010 9:00 AM
Reply posted for kshelef.
Here's what my doc told me (copied from MedicineNet.com) -
PREGNANCY: There are no adequate human studies of mesalamine during pregnancy. Mesalamine is known to cross the placenta into the fetus, but animal studies revealed no evidence of harm to the fetus. Mesalamine should only be used during pregnancy if it is felt that the benefit of its use justifies the unknown risks.
NURSING MOTHERS: Mesalamine is excreted in breast milk. Mesalamine should only be used by nursing mothers if it is felt that the benefit of its use justifies the potential but unknown risk to the infant.
That being said, I still took my Asacol (which is the same drug as Pentasa, just released lower in the intestines) - I just took less. I was able to get by on usually 2 doses instead of my normal 3 (some days, I'd forget and only take 1 dose and was ok too - NOT something I could do when I wasn't pregnant or breastfeeding). So, as I'm sure your gastro doc would agree when you call and verify with him/her, cut back your dose to as little as you can take and still feel ok. The baby can't afford for you to have a flare-up either ('cause prednisone is definitely NOT an option).
Good luck! And congrats!!
mismommyJoined May 7, 2010
Wed, April 28, 2010 12:00 AM
Reply posted for kshelef.
I agree with your docs on this one. My daughter, though not child bearing age yet, is on Sulfasalazine. I would give her the same advice.......it simply isn't worth the risk. Personally, I would never be able to fogive myself if something were to come up down the road that I knew full well could have been prevented at the time, but I am a very overprotective mom of two.
Joined Sep 9, 2009
Mon, April 26, 2010 8:18 PM
Reply posted for kshelef.
Hi,
I have been doing a lot of research about Crohn's Disease medications during pregnancy and while breastfeeding. The concern you posted is new to me. Anyway, I think this website might help:
http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
You can type in any drug name and it will give you peer-reviewed data/research on the medication and its affects on mother/baby (if known). It is specific to possible effects on lactation. There is information there on mesalamine that might be helpful.
Good luck.
Joined Dec 9, 2008
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