[Member Discussions and Questions] Medications for Rheumatoid Arthritis to Take While Breast Feeding?

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January 13, 2013

One Chick is asking for your feedback on medications while breast feeding:

I am on Prednisone and hydroxychloroquine combo that’s not working. I am thinking about going on Enbrel, however I am breast feeding and ideally would like to continue breastfeeding. She is 12 months old an very healthy. Would you be able to ask if anyone has breastfed on Enbrel? Or is there is any other med people have been comfortable breastfeeding on. Thank you!

Not sure what hydroxychloroquine is? Learn about it here. 

Thank you in advance for taking the time to help her out and answer her message. (((pain-free internet hugs)))

What our members have said so far:

Kristie – I didn’t feel comfortable taking any meds and breastfeeding. This is my personal opinion.

Debra – I wouldn’t do it. Enbrel has been linked to breast cancer. Breast feeding is a great way to reduce your chance of breast cancer. I took Enbrel for 2 years. Breast cancer does not run in my family. I now have a full mastectomy. My doctors have linked it to Enbrel. 12 months is a great start on life for breast feeding your baby. Most babies don’t get half that time.

Jennifer – Enbrel changed my life for the better. Prednisone & hydroxycloroquine (plaquinel) did nothing for me.

Amber – I am surprised your breast feeding while on Prednisone. I was told by my Dr not to because of the medication.

Brandi – My Dr wouldn’t let me be on Enbrel during that time. I had to take Prednisone.

Haley – Prednisone is okay for humans, but if it were me, I wouldn’t take anything, period. I would even check with my doctor before I took any vitamins. The infant’s little system is different from adults, and essentially your adult dosage of adult medications is being passed directly to your baby.

Andrea – Would you rather breastfeed or try a medication that help you stay functional for your child? Yes, breast feeding is great but you need to take care of you!

Bridget – I nursed on Prednisone, but waited until I was done to start Enbrel. Never looked back; Enbrel is life-altering. I waited til my son was 12 mos.

Danielle – There is one biologic that is suppose to be safe for breast feeding. I can’t recall off the top of my head, will report back. Any of these DMARDs increase our risk for cancer of some sort, as they reduce/affect to response of our immune system, which is our first line of defense against cancer.

Claire – I’ve done a yr bfding which is fantastic. personally I wouldn’t risk it. There’s not enough evidence either way to make an informed choice.

Liz – As someone whose body was damaged by breast-feeding on no medicine, I strongly believe it is better for our children to have healthy mothers than to get the marginal advantage of extended breast-feeding. If I could go back in time, I would have stopped breast-feeding early.

Vee – After twelve months the kid should be covered by all the benefits of breast feeding. I had to stop due to health issues at 3 months so I understand your distress. You will be better to remember you have a child who is still dependent on you for EVERYTHING. You can not be at your best when you are hurting. Prednisone is bad enough with the mood swings. Ask my kid!

Corrie – I resisted all meds for the longest time… But then became so sick I couldn’t look after my son (and work and be a wife – we all know the drill). I finally relented and took sulphasalazine (and later added hydroxycloroquine). I had monthly blood work to monitor my blood levels. He was older than your babe (I think he was 2 – I nursed until he was 3.5 . They didn’t make me 100% and I ended up having to stop because i had to start MTX.

Adella – I was only allowed a low dose of prednisone while breast feeding my babies.

Callie -She needs to consult her pediatrician or obstetrician so that she is not taking something harmful to the baby. Obviously, there are some drugs that transfer to the baby through the milk more than others and others that don’t. I just got done breastfeeding and was told previously by the lactation consultants at the hospital, the ob/gyn and the pediatrician that hydroxychloroquine (plaquenil) and low dose prednisone (< 5 mgs) was OK and that plaquenil was the only RA drug OK. Also ibuprofen was OK, but no more than 600 mgs at a time. Not to sound snarky, but I would take the medical expertise of a doctor over the advice of someone on a blog when it comes to non-safe/safe drug interactions.

Kim – I was dxd and they wanted to start me on all sorts of stuff while I was still breastfeeding…she was almost 12 months at the time… I weened her at 14 months and started meds after… it was hard I was miserable but…  I did what was best for her…now 6 years later I decided to stop all meds and try a more natural approach… acupuncture and vitamins it has taken 6 months to start working but i fell great now…. point being you have to decide what is best for you and your baby…. there are a lot of options to get relief… had I known about acupuncture back than I would have tried it while still breastfeeding…

Danielle – Here are a couple links, meds & breast feeding:

Mary – Heck,I’m scared taking the meds now.I’m past the child bearing days but every time you turn around there is a lawsuit on TV about taking meds.  They were the new wonder drug of the time only to cause a host of problems down the line.DR.’s can tell you it’s perfectly safe to take them while breastfeeding but in reality they don’t know for sure.I wouldn’t risk it.

Amy – I read that remicade is safe during pregnancy (I was surprised) so I “guess” breast feeding would be OK. But I feel the same as Kristi, I wouldn’t chance any med, not even prednisone

Tammy – I wouldn’t

Mel – I am on Enbrel was told not to get pregnant with it so I surely wouldn’t breast feed

Lynsey – I am breastfeeding on sulfasalazine and prednisolone. My doctor won’t give me anything else.

Jessica – We breastfed until 2 so I understand the desire to but I would not bf on Embrel. While breastfeeding past 1 is certainly beneficial, I personally think the transfer of the strong meds negates those benefits. A big congratulations for nursing to the year!!!

Linda – Your child is blessed to have been breastfed for 1 years. The benefits are delivered. Now time to protect her long-term health. Side effects of this are unknown. See from “…long-term follow-up data on infants breastfed during maternal Etanercept use are not available. The risk of adverse effects in older infants is not known, but thought to be unlikely.[1] Some experts feel that the drug is a low risk to the nursing infant and can be given during breastfeeding.[2] However, until more data become available, an alternative drug may be preferred…”

Jeanne – The side effect of the meds is scary enough without breast feeding a baby. I would personally decide how bad I felt to the benefits of cont. breastfeeding.

Joanne – I would get on Enbrel and stop breast feeding. Since it is recommended that 12 months they get the most benefit now its time to get your body under control! You should be proud to have made the 12 month mark.

Tammy – You cannot safely nurse while taking biologics. Wait until the baby is weaned, but remember you can’t be a good mommy if you don’t take care of yourself too!! Perm joint damage cannot be repaired. Good luck.

Joanne – There was also an Otis study that I participated in out of San Diego. They might be a good resource. The study was women who were taking Enbrel sometime during their pregnancy.

Marcy – NO breastfeeding while on those meds. The only one that is safe is prednisone. Be careful.

Rebecca – Check out the OTIS studies. My lactation consultant, paranatologist, and rheumy all have said that what little is transferred to the baby via breastfeeding gets digested in their tummy. That said, I am not sure I would have done it, given the option. I was diagnosed eight mo after my son was born and my RA was so bad that I couldn’t perform basic tasks (like walking or using the potty by myself) let alone continue to bf my son. I had to get over feeling like a failure and get myself healthy. I am saying this because at some point you have to take care of you. You don’t want your joints to deteriorate because you will want to be at your best as your baby gets older.

Stephanie – You should look at the OTIS Pregnancy at UC. They have long term results of Biologics and pregnancy and breastfeeding. I took Remicade while pregnant and breastfeeding because research shows it doesn’t pass through the placenta or breast milk. For the record, the only type of cancer that has been associated with biologic use is lymphoma but the rate is negligible — like 3 per 100,000. The folks at @OTIS are great and their research is unbiased since it is not funded by drug companies. Read the research not just the headlines

Cyndi – Consult your doctors, the Le Leche League, then weigh the benefits and risks. I chose to avoid all medications while I was nursing my son, but this was after doing all of the above. I will admit, it was a very painful year, but I felt it was best for his health not to take any chances.

KT – I breast fed my second while on humira. I restarted my humira the day after he was born. Helped prevent/reduce the severity of the 6-7 week post birth flare. I was also taking anti-inflammatories

Tracy – I did a lot of research and I made the decision to continue nursing good luck. I struggled with this so much but have been breastfeeding since March while on biologics and my little one is doing great

Kay – I am still nursing my 14 month old and taking plaquenil, sulfasalasine and prednisone, all are considered safe for breastfeeding. My doctors want me to wean so that I can start MTX but I am not ready to wean yet and my xrays show no damage to my joints so I am choosing to continue bfing til we (baby and I) feel ready. Good luck!

Nilsa – I’m sorry but I would not breastfeed any child while on those meds. You know what they do your body just imaging what they are doing to your child. The side effects might not show now but they will surely show in the future. Sorry but its my personal opinion. Good luck.

Betsy – I had to stop breast feeding before I started enbrel because there is not enough information to know how safe it is. My doctor would not even prescribe it until my daughter was weened. While some drugs are considered safe, all drugs you take can pass through the milk. I know it’s hard, but if you are at a point where medication is not working enough, you may need to ween her. I nursed my oldest until she was 2 (no meds), so I am not one to push formula. But, because your daughter is old enough for cow’s milk, it would be an easy transition. Good luck!

RA Warriors Philippines – Enbrel still has some side effects and the number varies from patient to patient. I’m a dad and I think it is better for the baby to be safe, first and foremost. However, formula substitute my be consider in replacement for breast milk. Hope you get better!

Kay – I breastfed for six months drug-free and stopped nursing to start treatment (plaquenil+MTX) because I could barely function. The WHO recommends breastfeeding for at least 6 months. You’ve done more than enough for your baby–it’s time you do something for yourself.

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The above is a discussion created by a member and with member generated responses from our Facebook community ( put into a format so that the discussion can be archived for future answers needed by others in a searchable format while keeping member anonymity. Member provided information, statements and opinions do not reflect on or all individuals with Autoimmune Arthritis. We encourage all members to seek professional medical advice for any specific questions and concerns as this does not substitute competent medical care.

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