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Asacol and breastfeeding? and Pregnancy update.

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Ulcerative Colitis
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Posted 10/5/2007 3:17 AM (GMT 0)
Hello all,

I haven't been around in a while, and there looks to be a few new names, so some may not remember me.  But anyway, I am now 33 weeks pregnant and doing great. (I stuggled to decide if I wanted to try pregnancy b4 my colectomy, but things happened naturally)  I had the best first two trimesters!  I felt better than I have in years.  I am still technically in a flare, but managing it with drugs.  My symptoms are back under control, for the most part-only 2-3 bm's per day (awesome) and only occasional blood-all stools are play-dough due to strictures.  My baby is also doing great.  SHE's a big girl for 33 weeks- 4lbs 13oz (approximately) and they want me tested for gestational diabetes AGAIN.  Thank you prednisone confused grrrrrrr.  But at least I'm not anemic.  And considering how sick I've been in the past, I'm VERY thankful to be pregnant and doing so well.  The OB's have told me they will induce me at 39 weeks if I haven't had her by then b/c of full term complications (I don't really understand what complications, but she'll be full term and I won't have to wait any longer).

So there's a bit of history. 

My main question is about asacol and breastfeeding.  Has anyone been on it while breastfeeding?  I would really like to be able to breastfeed b/c it's better and with my history of auto-immune dz, I want my baby to have an advantage on immune system.  I looked up asacol in a breastfeeding book and am worried now that it may be too risky to try.  There are not alot of studies (DUH-like every drug and pregnancy/breastfeeding) and want to know about anyone else's experience.  Also the mg you were on.  My thought is that if it's ok for pregnancy, why not for breastfeeding too. 

Thanks for any input.

p.s. I feel like I typed the word breastfeed way too many times :-) !

Posted 10/5/2007 1:56 PM (GMT 0)

Hi, 

Congratulations on your pregnancy!  I'm glad everything is going smoothly.  That's great.  My pregnancy went pretty well until the last trimester when I started flaring, so fingers crossed that doesn't happen to you.  My only advice is to be vigilant about your UC post-delivery - mine flared really badly after I had the baby and I wish I'd been more careful about getting it under control because it ended up spiralling out of control . . .

Anyhow, this isn't to scare you - I just wanted you to avoid my mistakes because I had to stop breastfeeding at 5 months because I had to start taking really high doses of prednisone and the doctors weren't comfortable with me breastfeeding while taking so much prednisone.  However, they were fine for the first five months with me taking asacol and using enemas.  I did quite a bit of research on medication and breastfeeding and while some medication warnings for asacol say "don't take while breastfeeding", most experts seem to agree that it is fine as it doesn't pass through the breastmilk in doses large enough to affect the baby.  I can't find the links right now, but if you google Dr. Hale and breastfeeding, you'll find a wealth of information on his website.  He quite literally wrote the book on breastfeeding and medication.

Good luck!

Posted 10/5/2007 10:02 PM (GMT 0)
CONGRATS!!! First off I don't know why you are being induced early.  I have had four children with UC and never been told that.  Don't let your doctors convince you into something because they are scared of your disease. That is how I ended in a c-section with my first the doctor he thought I was going to have more complications if I didn't control my pain yada yada.  So I followed all his steps during my labor and ended with a c-section (idiot).   My last OB Dr. gerdes I have had 2 children with when I first started out with her she wanted a c-section she was worried the entire time about my disease and I had alread had a sucessful V-BAC (vaginal birth after cesarean) she ended up realizing I was fine.  Had another sucessful V-BAC without any drugs (HAH to my first dr.)  and it was my best birth. By the time I had my 4th with Dr. gerdes again.  My body had enough of pregnancy and I was hospitalized and well I am alive and recovering.  It did end in a c-section but that is by my choice and Dr. gerdes was so much smarter because she had a UC survivor under her belt. So what I am saying is you be the boss and go with what you feel is right. You would rather have a regualr birth then deal with a c-section.  Second redheadedmama is right make sure to really take care of your disease after birth. I too have issues after each birth like I was saying just had a my last 6 months ago. This is something I have noticed with myself that my female hormones seem to make me flare so my pregnancies are the worst usually by the third trimester.  Every pregnancy has been like that.  I also have nursed my boys with Asacol and I am currently on Lialda which is Asacol but in a once a day dose.  They say it won't get in your breastmilk based off of how it is absorbed in your colon.  I believe that however I stopped taking it with my second son because he was so fussy and I had taken away everything in my diet already and that was the last to go and he seemed to be less fussy after I did.  I call it a fluke since my 3 other boys were just fine and the one I am nursing now has all sort of issues with his digestion but I am taking Lialda still and he doesn't seem to mind it.  So you can breastfeed with ease.  I hope this was helpful I amf eeling like maybe it was an overload of info.
Posted 10/5/2007 11:10 PM (GMT 0)
Actually, I did forget to mention that at the start of my third trimester, I started to flare badly, but I upped my prednisone and now I'm feeling better. (plus I think it was stress that triggered b/c my bro was going to be deployed to Iraq, but sent to Germany temporarily). My Dr. says that I have to get a shot of steroids when I go in labor b/c labor tends to cause a flare. I asked if I really need them b/c they make me lose my patience and she warned me it was best. I'm not really upset about being induced, b/c 39w is long enough for development, and if she's cozy in there, at least I won't be late.
Thanks for the breastfeeding advice. I went to a breastfeeding meeting last night and the lactation consultant had a medication and breastfeeding book and I looked up all of my drugs and the only one that caused concerned was asacol and it does pass into the milk, but in small doses. But that was studied with the patient dose at 800mg 3xday. and I'm on 1200mg 3xday. I called the pediatricians office I've chosen, but the nurse said she can't help me until the babies born......whatever! I still think I'll try to breast feed, but I want to get all your experiences first. So thanks.
Posted 10/5/2007 11:34 PM (GMT 0)
yeah with your severe situtation a shot is a great idea...man wish they had offered that to me. C-sections are tricky with it though because of the healing. No worries though you eventually do. I am curently taking as much as you. So it is good to see that maybe my 2nd son was having trouble with it and it wasn't a fluke. Just in case you wanted to know my oldest is 8 1/2 now and each one of my kids are normal healthy kids. They all breastfeed with the meds.
Posted 10/6/2007 12:32 AM (GMT 0)
hi!
i'm still nursing my son and taking 6 asacol per day.
my OB talked with his pediatrician and they both decided that the only concern was with Reye's syndrome. asacol is similar enough to asprin which is a no-no for kids.
so they just told me to look out for signs of the flu in him. if i thought he had the flu, they said to pump and dump the milk for a while just to be safe. but we never had to do that.
thank goodness too because i can't imagine getting him thru the flu without the comfort of the boobies! :)

and i was also at 40mg of pred when he was about 9 months old without any of the doctors worrying about that at all.

good luck with the rest of your pregnancy. get the rest while you can cause that is about to end! :)
hope you have a great birth experience!

aloha
Posted 10/10/2007 7:45 AM (GMT 0)
Hi - I'm also pregnant, and I'm taking 6 Asacol a day, and using Mesalamine enemas a few times per week.

So, if I'm understanding correctly, is it worse for us UCers to have a c-section b/c of healing? I guess it would be harder to heal if you were flaring. I had a vaginal birth w/ my first child, but I had a midwife who was able to avoid an almost necessary c-section. I'm just worried about doctors that are quick to give c-sections...this may be something to bring up?

Also, I was in remission w/ my first pregnancy, but got really sick after I gave birth, refused to go on any meds so I could continue to breastfeed until I had to stop when my son was 11 months. I have not been in remission since, and he's now 3 years old. This time, I will definitely stay on the meds (though they haven't put me in remission either, but atleast manageable).
Posted 10/10/2007 11:41 AM (GMT 0)
I, too, am pregnant and am taking Asacol. I use a Rowasa enema as needed. Interestingly enough, my GI is recommending a c-section. He recommends a c-section because if I ever need surgery to have my colon removed, a j-pouch will not be an option if there is damage to the pelvic floor from labor. My GI and OB are in communication, but my OB is reluctant on the c-section for this reason. I am carrying breech right now, though, so it may all be moot and I may need a c-section anyway. I'm only 5 months along now, so they are going to reconvene at 8 months and make a final decision from there.

Neither one of them, though, has ever mentioned any healing issues, but I am definitely going to ask them about it now! No one mentioned steroids during labor either, and I am going to bring that up, too. Thank you for the great information!
Posted 10/10/2007 12:51 PM (GMT 0)
I had two boys, two years apart. With the first pregnancy, I flared around 12 weeks and I managed it okay with Asacol, but after giving birth, I went into the worst flare I've had. I then went on prednisone, but never nursed my son because I was so very sick and he was in the NICU for 2 weeks. The 2nd pregnancy was a constant flare, but upon giving birth, literally that night, I had no more issues with uc for 2 years! I nursed him for 8 months on Asacol, and he's just fine. My first son was born at 35 weeks and I went into preterm labor at 31 weeks with my second son. I was able to go almost 37 weeks. Not sure if any of that is uc related or not, because I know some uc'ers have full-term babies, but just thought I'd add my experiences.

Again, I have been on Asacol during both pregnancies and nursed the second son with no side effects for him.

Good luck!
Posted 10/10/2007 1:49 PM (GMT 0)
My daughter is now 12 years old but when I was pregnant with her I started off flaring horribly but luckily after the 1st trimester, I went into a glorious remission until 6 months after I had her. I was on Asacol only when she was born and I nursed her for about a month or so. I stopped nursing her because I couldn't do it anymore. But I checked with my GI, my OB, and a nurse at the makers of Asacol about any complications of taking Asacol while nursing and all of them agreed that it wouldn't harm her. Things may have changed since then but I believe that it's still true that it's an all around safe med to take while bf'ing. The only thing I'm wondering now is she has decalcification in her teeth and the dentist had asked if she was on antibiotics a lot as a baby, which she wasn't, in fact she was super healthy. So I think that maybe the Asacol contributed to her soft teeth. I asked the dentist this but she wasn't sure.
Posted 10/10/2007 9:05 PM (GMT 0)
Thanks for all the good info on your experiences...Snooker, I am praying that I will go into remission after this baby is born, b/c it was so hard to be so sick w/ an infant the first time!! How lucky you were. Did you continue to take Asacol through remission for 2 years?
Posted 10/10/2007 11:32 PM (GMT 0)
Hey Ali G,

Yes, I continued with my Asacol throughout. When I had my second son, I had a 2-year-old AND my husband was deployed (he didn't come back until the baby was almost 5 months old!), so I didn't want to change a single thing since I was feeling so great! I have an appt with my doc in 2 weeks and I plan on asking him about tapering asacol (I would never stop taking it completely, but maybe I could reduce my dosage). While I was nursing my son, NEVER did I worry about asacol affecting him. Being sick is a greater risk in pregnancy and like I said, I didn't want to be sick with a newborn either. It was almost like when I gave birth, all the hormones went out the window and I felt awesome. Think positively, say prayers and I will too! Because I was early with 2 babies, I always tell my pregnant friends to be prepared, as you never know when that baby will want to come out. Good luck!!
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