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Breastfeeding while on 6mp?

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Crohn's Disease
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Posted 1/13/2015 7:46 PM (GMT 0)
Hi everyone, I would like to know how many of you breastfed while being on 6MP? I went off of it before I got pregnant and I'm now flaring up again. Currently I'm on 40mg of pred and I need to start back on 6mp. While the books say you shouldn't bf while on it, GIs tend to be more liberal and say it's ok... The thing is, when it comes to your baby, you don't want to mess up with them :(. My GI said *if* some of it passes thru breast milk, it's a minuscule amount. It's not like I have a choice, I do need a maintenance meds (5asa failed), but I just need some comfort from people who did it before me!
Thanks !
Posted 1/13/2015 8:15 PM (GMT 0)
From the breastfeeding page at infantrisk.org (http://www.infantrisk.com/content/inflammatory-bowel-disease-pregnancy-and-breastfeeding):

http://www.infantrisk.com/sites/default/files/files/IBD%20drug%20table.pdf

There is no entry for 6MP, but for azathioprine it says "Multiple trials suggest infant exposure is minimal with no adverse effects reported. Monitor infant for immunosuppression." The estimated dose of meds transferred to the infant is 0.07% - 0.3%.
Posted 1/13/2015 9:48 PM (GMT 0)
If you decide to go another route in trying meds, I breastfed while on Remicade with zero problems. Remicade is too big to pass through to breastmilk.
Posted 1/13/2015 11:51 PM (GMT 0)
I used to be on 6mp as a booster to remicade but everyone made me go off of it in April after they found out about the baby. I have a GI appointment in two weeks and I'm worried he'll want me to go back on the 6mp. That lousy drug took 3 months to kick in and I felt like crap the whole time! And within a few months it made me lose hair. ugh
Right now I'm only on remicade and breastfeeding. Baby boy is small and awesome. We're just not giving him any live vaccines for awhile. I, however, had a week of rectal bleeding recently, but I'm not sure if that is CD or a postpartum symptom.
How are you Crohnie mamas doing??
Posted 1/14/2015 12:15 PM (GMT 0)
Thanks Kazbern for the link. That's reassuring!

I hate that some GIs say no to 6mp while pregnant and/or bf'ing and others will say it's all fine... Then the decision is all up to me. Sigh. I have to go back on it, my doc didn't propose remicade as I've had great success with 6mp.

I was doing really good up until October. I was two years off meds, as I stopped before TTC. I felt the best ever during this time! (Well, up until October). While 6mp kept me in remission, I was always sick with viral infections, nauseous and just not feeling 100% on it. It *is* better than being in a flare tho. Now I feel like crap, no energy, and I have to take care of a busy 9 month old... Ah well. Hoping for the Pred to kick in soon!
Thanks ladies!
Posted 1/14/2015 2:48 PM (GMT 0)
Hello,

Anytime I ever have Breastfeeding questions with regards to drugs I always call Motherisk.. They are awesome... They have all the up to date and current studies with any drugs. You just call and leave a message and they call you back within a few hours... Excellent resource!!

1-877-439-2744 Monday through Friday, 9 a.m. to 5 p.m. in each of Canada's time zones OR 416-813-6780 9 a.m. to 5 p.m. EST for information about the risk or safety of prescription and over-the-counter drugs, herbal products, chemicals, x-rays, chronic disease and infections, and everyday exposures during pregnancy and while breastfeeding

Good luck
Posted 1/14/2015 2:53 PM (GMT 0)
It is important that you have as much information as you can, because only you know your own tolerance for risk.

For example, you said that you were constantly ill on 6MP. Why are you taking it now? With a young child you are going to be exposed to even more random viruses as your kid brings home lots of germs. I encourage you to talk to your GI about these issues. You need to insist that your treatment give you the quality of life that you deserve.

With breastfeeding and pregnancy, a lot of doctors just default to "no" because that is the lowest risk answer for them. I got shingles 6 weeks after giving birth and no one would treat it until I called my ob/gyn. My GP told me I'd have to wean my baby before he'd give me antivirals (!!!!!!! I never went back to him).
Posted 1/14/2015 3:26 PM (GMT 0)
kazbern, you are totally right that I need to gather as much info as I can in order to make my decision. While being sick with viral infections suck, it is much better than being in an active crohn's flare, so I can live with that. I was in remission for 10 years on 6mp! I am planning on giving it a try again, and if I do find that my QOL is impaired because I feel crapty, I will certainly discuss it with my GI.

As for breastfeeding, we now know that very little actually pass through it. For example, drinking a glass of wine is ok. I breastfed right after getting out of surgery (had my gallbladder removed this summer) and after my scopes this week. As long as you feel fine enough to sit and hold your baby safely, than it means the amount of drugs in your system is quite low. That being said, 6MP is a daily drug and it *is* an immunosuppressant, a chemo drug used in leukaemia! Yes, the dose might be (slightly) different, but we are on it for so much longer than leukaemia patients and in the end, the cumulative dose for us is higher. I'm not worried about the acute side effects if my child gets it through my milk, but rather the long term effects... Her paediatrician actually did some oncology training so I'll talk to her as well.
Thanks for the support everyone!
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