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Asacol and Breastfeeding

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Posted 1/18/2008 7:09 PM (GMT 0)
So I asked my GI yesterday, who specializes in UC and pregnancy and she said that asacol is a category B drug for pregnancy and that you can be on it while BFing.  Some babies do have a reaction to it and that reaction is D. So if the baby has D then you either have to stop BFing or stop Asacol.  Anyone have any evidence that Asacol can HURT/HARM babies while BFing?  If so, please share.  I'm going to start trying to conceive #2 next month, so this info would be handy.  I had to BF Baby #1 due to her dairy and soy protein allergies(she couldn't take ANY formula and we tried them all, including the super expensive hypoallergenic ones).  She is doing great now and has overcome her allergies, but I odn't know what I would have done if I couldn't BF.  I might think about using Rowasa while I am BFing as I was in 100% remission last time I BF and really don't think I really needed any drugs...  I want to have all the facts before I decide what to do.  Thanks!
Posted 1/19/2008 12:11 AM (GMT 0)
I took Asacol while pregnant with my second son. I also took it while breastfeeding, I breastfed till he was a year old. No problems. My Gyno and GI said it was totally ok, my GI said it goes straight to the colon so very little would be passed to the baby, but I can't guarantee he was right. I say to start trying for a baby NOW while you are doing well and not having to take anything like Remicade. I am so glad I had my boys when I did because I wouldn't be having them now with how sick I am and the meds I am on.
Posted 1/19/2008 6:46 AM (GMT 0)
When did the Asacol stop working for you Princess? That is my wonder drug right now and I am always scared that it will stop working one day. I have relatively minor UC, but I am always scared that it will get worse. Was yours minor and then suddenly got worse?? How do you take care of your kids when you are sick. I am so scared of that...
Posted 1/21/2008 7:04 PM (GMT 0)
Anyone have any info on Asacol and BFing??  My doc says it is fine and I know others said their doc said not to.  I'm wondering if anyone has any scientific info on the harm/possible issues with it and what their docs told them when they told them not to.   Thanks!

Posted 1/21/2008 7:15 PM (GMT 0)
I have a one year old and an almost 3 year old and I bfed them both while on asacol.  I also used Rowasa.  Both my OB and GI were fully aware and had no problems with it.  There were no adverse reactions to either of my daughters.  It obviously is a personal decision but for me I felt the benefits of breastfeeding outweighed any apprehension I had about asacol.  Good luck to you.  I felt better (in terms of UC) the whole time I was pg and bfing.  I hope it is the same for you!
Posted 1/21/2008 7:24 PM (GMT 0)
i also nursed while on asacol with no problems. i had to stop nursing when i moved to imuran (baby was 4 months old) though.
Posted 1/21/2008 7:24 PM (GMT 0)
i also nursed while on asacol with no problems. i had to stop nursing when i moved to imuran (baby was 4 months old) though.
Posted 1/22/2008 2:25 AM (GMT 0)
Dear Jen, looking back, I was fooling around with my Asacol dosage and lowering it on my own without speaking to my doctor, to 4 pills or 2 pills a day. Then I tried to take more again and it didn't work. So my suggestion would be to stay at the dose that is working for you, and hopefully you won't have that problem. (kicking myself right now)
Posted 1/22/2008 5:45 PM (GMT 0)
Phew...ok thanks Princess. Been there done that so I feel your pain. Now that I have a good GI I won't ever play around with the dose on my own anymore, but I know the feeling of "I'm better..I don't need it!". Just freaks me out when people say it just "stopped working" for them....

Thanks for all the advice on BFing guys. I know someone said their GI and OB/GYN said not to BF on it, but maybe they were just very cautious docs. I BF on Rowasa last go around and had no issues. I am hoping to do the same with Asacol when I conceive #2.
Posted 1/22/2008 6:30 PM (GMT 0)
*Jen*-- I do believe that Red_34 wrote in another thread that Asacol while BFing decalcified her daughter's teeth. Maybe she'll see this & clarify. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])

Posted 1/22/2008 6:49 PM (GMT 0)
I think I might have been the one who said they were advised not to BF on Asacol on Rowasa in the previous post. 

I am currently 36 weeks pregnant and have been researching this from the beginning.  After conducting my own research, reading Dr. Hale's book, Medications and Mother's Milk, and discussing with my OB, GI and three different Pediatricians, I have decided against breastfeeding.  All Drs. that I consulted advised against it, as there is no doubt that the medication is secreted via breastmilk.  Like *Jen* says, some babies had problems with the mesalamine and developed watery diaarhea as a result. 

Interestingly enough, Dr. Hale says that he really doesn't know if it is alright to breastfeed on mesalamine.  His studies show that some babies had problems with it, so as a result, he will not say that it is perfectly alright.

My view is that even if my son does not develop diaarhea from my mesalamine use, the medication will still be secreted through the breastmilk and he will still be ingesting it.  I do not want him to begin his life taking my medication... especially when no Dr. can assure me that there will not be any problems in the future.

Obviously, this is a personal choice for every mother and father... but this is the choice that we have made.

Posted 1/22/2008 6:58 PM (GMT 0)
There is an interesting discussion going on over at the Crohn's forum re: 6mp and breastfeeding. Here is the link, if you are interested. https://www.healingwell.com/community/default.aspx?f=17&m=1025214
Posted 1/23/2008 12:47 AM (GMT 0)
Interesting. I totally hear what you are saying and agree that it is every parents decision whether to BF or not. For me, I HAD to breastfeed. My daughter was incredibly protein intolerant to soy AND dairy and I tried every formula out there(even the expensive $30+ a can ones) and she would not tolerate them. I am on a low dose of meds. Currently only 6 asacol a day and when I was BFing I was only on rowasa enemas and I got down to one a week because BFing actually kept me in great remission(YEAH!). So for me, the small amount my baby got, was ok because of the other factors(how great breastmilk is for the baby and the fact that she couldn't tolerate formula). So..with the next one, if they aren't protein sensitive(god I hope not), I will have to decide if it is worth the amount of mesalmine they will get. Do the benefits of BFing outweigh the fact that they will start life with "drugs in their system". Hard question. Right now I am leaning toward yes, because my daughter did so great on breastmilk and she was so healthy(even in daycare) compared to other kids. But, I need to do more research. Luckily I haven't even conceived yet, so I have some time to decide.

Thanks for sharing everyone. Once again..I LOVE THIS FORUM. What would I do without it??
Posted 6/17/2008 6:10 PM (GMT 0)
Hi Ladies,

I have been going back and forth on this one like a ping pong ball.  I am 23 weeks pregnant and have been thinking about this since day 1.  It's a really tough decision to make as I too have been doing research and can't seem to get a definitive answer.  My doctors have been telling me that the initial studies show that there is no impact on the baby but my fear is that the studies have been so limited I don't know what the long term impacts could be.  Plus, I have no idea who is funding these initial studies....for all I know it could be the drug companies!

So I have yet to make my decision...it seems like my answer changes every day as I read a new article or opinion!  At the end of the day though...if my doctors were serioulsy concerned about it, all three of them would have said no and to just bottle feed so I have some reassurance there that at least in their opinion, it's not harmful.  As well, I am currently taking asacol and salofalk so I am already exposing my little boy to this medication already...

 

Posted 6/18/2008 2:04 AM (GMT 0)
breast milk is tailored to your baby's needs-the first few weeks' milk is packed w/ immunoglobulins to keep their immune system healthy. your digestive tract is sterile at birth, and breast milk plays a big role in establishing the right flora in baby's insides. i've read some preliminary studies out of Europe linking "inadequate breastfeeding" to UC and Chrons later in life, though I don't know if I'd go so far as to say there is a definite link. breast feeding has been shown to reduce middle ear infections though, and athsma risk, among other things.

asacol is in the same family as asprin, and is only secreted in small amounts in the breast milk. for me, i'd rather take the risk of transferring an asprin-like medicine to my child than to miss out on all the things breast feeding does offer, espeically in terms of maternal antibiodies and such. at least for the initial months.

have you considered doing just a short course of nursing? the first 6 weeks are when the antibiodies/flora are being established; you could just nurse in the beginning, and then wean to bottles after the initial weeks.

not an easy decision though, no matter how you shake it out.
Posted 6/18/2008 6:27 AM (GMT 0)
hi lilypirker,
i know it is freaky to think about giving your child something that they're telling us is okay but wondering all the while how they can REALLY know what the long term effects are.
you just have to decide what is more important to you and what you feel safest giving your baby.
i nursed my son for 2 years and was on asacol from the time he was 6 months old.

keep in mind that the FDA who tells you that asacol is safe, are the same people who tell you that baby formula is safe...

hope you come to a decision that gives you peace of mind! :)
Posted 6/18/2008 2:04 PM (GMT 0)
Thanks hekela....I am leaning more towards the breastfeeding....as tooth fairy said....the benefits seem to outweigh the risks....as we know them anyway. This forum is so great, it is really reasuring to know others are in the same situation as me. Sometimes with the whole UC thing I find myself constantly explaining things to people.....it's such a comfort to know that there are others who REALLY understand what I am going through..... :)
Posted 6/18/2008 5:13 PM (GMT 0)
yep, it is more helpful than i would have imagined to have this great group of people.
there is always someone here to give advice or at least moral support and that is often what we really need.

hope your pregnancy is going well! i'm 27 weeks now and feeling really good most of the time. but tired. i'm also planning a home birth this time around! i'm excited about that. :)
Posted 6/18/2008 5:48 PM (GMT 0)
Thanks! so 27 weeks huh? I am 23....what an exciting time! So you are planning a home birth wow! Good for you! Being my first I am too scared and I don't want to be too far from that epidural (sp?) LOL Anyway, good luck to you and congrats to you and your family!
Posted 6/18/2008 7:10 PM (GMT 0)
I don't have any information for Asacol, I had no response to that med when I took it originally, after 3 months I asked for them to try something else.

I did however take Colazal through my pregnancy and BF for a year. My son is doing fine

If there's a LaLeche group in your area try contacting one of their counselors, they are a great source of informational resources. They are good about not pushing you in any direction other than in the information direction. I contacted them when I found out about my stage 3 kidney failure, they just gave me tons of information and resources I could look up on my own so I had all I needed to make my own decision. . .they never pushed me to decide for or against BF. . . they just supported me in my decision whatever it was. Yes there are mothers there that are BFing 2-3 year olds still but not one of them looked down on me when I had to stop at 12 months due to my health. . .in fact they all congratulated me for making it as far as I did. They did the same for my sister that stopped BF at 4 months. . . to them some is better than none but if in the end you choose none. . . .you made that choice with a wealth of information and they respect that.
Posted 6/19/2008 4:25 AM (GMT 0)
yeah i did a hospital birth with my first and was glad to be there "just in case".
but i was also really against using pitocin or any meds if i could help it. that was just me tho.

anyway, i totally understand wanting to have pain relief close by because you just have no idea what to expect!! if you have any desire to try a natural birth, i HIGHLY recommend the bradley method. amazon has a great book "natural childbirth the bradley way". and then if it doesn't work for you, you're only out $15 on a book and you could still opt for the epidural! haha

congrats to you too on your first!! how fun!

oh yeah, and ditto what peanutmom said, definitely look into a local la leche group. they will have lots of info for you now and could be very helpful if you decide to start nursing. it's really nice to have support for nursing sometimes, even if things go really well. i went to a meeting when i was pregnant with my first and then went to several after he was born.
Posted 6/19/2008 1:23 PM (GMT 0)
Thanks for the info! I will look into that book....if anything, it will help me prepare at the very least...no harm in that! I will look into la lache for sure. I have heard of them before. Plus the hosptial has lactation consultants on hand all the time so I think I will be ok! :) Thanks again!
Posted 6/17/2009 7:20 PM (GMT 0)

I take Asacol for Crohn's colitis. I took it through my pregnancy with no problems. I breastfed my baby while taking it and at about 5 weeks of age he developed very bloody stools. They were full of mucousy blood at first, then it progressed to profuse watery diarrhea that was very bloody. I spoke with my pharmacist who advised me that although many women bf with no problems on Asacol, there have been a few reports of watery diarrhea and bloody stool. I really really didn't want to give up bfing but I couldn't in good conscience continue to cause harm to my baby. His stools improved immediately on formula.

 

I am aware that milk protein allergy can cause bloody mucous in babies stools, but I have a milk protein allergy as well as lactose-intolerance so I don't consume dairy, thus eliminating that as a possible cause. The only medication I take is Asacol, so it had to be the drug. I tried reducing my dose significantly before switching to formula, but even the reduced dose caused bleeding symptoms for my baby.

 

I wish wish wish that I had been one of those women who had no problems nursing their baby on Asacol, but unfortunately I am not. I just thought I would post this, so those of you who are going to breastfeed can be aware that this can happen and to watch your baby's stools for changes that could be attributed to the drug.

 

Lori
Posted 6/17/2009 9:05 PM (GMT 0)
I was on Asacol from 5 months pregnant when I was diagnosed and continued to take it and breastfeed until the baby was 2 months old. I am not taking it now since I have started Remicade and the Asacol never helped anyway. The baby never had a reaction to the Asacol. I am more concerned about the high dose of Prednisone I am on
Posted 6/18/2009 10:06 AM (GMT 0)
What an interesting and helpful discussion. I had the same questions when my 8 month old was born. Dr. Hale is the main source for other Doctors, La Leche League etc. If you google him he has an online book that is updated as needed. I paid a small amount for a piece of mind. I used that in conjunction with his online forum (free) do some searching on there and you will see many discussions on this topic. The main idea that I got from it was that over 3800 mg is too much and Dr. Hale starts talking about Rye's Syndrome from the aspirin base. But then the other side of that is that babies/children who have to take aspirin for things such as childhood arthritis had a very low rate of Rye's and they took it directly vs. the small amount in the mother's milk. When I was at a high dose I lowered in so I could still breast-feed safely, but I believe if I had just made sure not to breast-feed if my son had a fever it would have been better because I am now on Remicade a heavier drug that is safe during pregnancy and breast-feeding but it of course lowers my immune system which lowers what my son is getting from the breast milk. I think me being over cautious may have made my issues worse:( The choice is so individual. I wish you the best with yours.
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