Abstract
It is very natural to be concerned that immunosuppressive medications might be deemed hazardous to infant's breastfed by mothers who are transplanted. This is due to lack of good quality guidelines supported by robust evidence. The drugs that are not safe during pregnancy are not necessarily unsafe during breastfeeding. On reviewing non-transplant patients, we noted that there was no adverse effect reported in infants who were breastfed by mothers receiving steroids even in a high dose of prednisolone 50mg/day. Azathioprine levels were undetectable in breast milk or in infant blood and were not associated with increased risk of infection on a long-term follow-up. Cyclosporine levels are undetectable or at insignificant levels in infants breastfed by mothers on this drug. Tacrolimus levels were detected in infants' serum but at insignificantly low levels. In regards to mycophenolate mofetil and belatacept, the data based on animal studies is rather limited. There is still no conclusive evidence regarding the safety of motor inhibitors during breastfeeding. In conclusion, it is safe for mothers to breastfeed while on immune suppression that includes steroids, cyclosporine, tacrolimus or azathioprine. Nonetheless, a close follow-up of these infants is of paramount importance
Highlights
Women of childbearing age, who have had a renal transplant and wish to conceive, are faced with a dilemma in regards to the safety of breastfeeding
An electronic search was performed for scientific papers using the following keywords: safety of breastfeeding and immunosuppression, renal transplantation, cyclosporine (CsA), tacrolimus (TAC), azathioprine, mycophenolate mofetil (MMF), everolimus, sirolimus, belatacept, and steroid
There are no specific trials on MMF, sirolimus, everolimus or belatacept that addressed their safety during breastfeeding
Summary
Women of childbearing age, who have had a renal transplant and wish to conceive, are faced with a dilemma in regards to the safety of breastfeeding. This question is pertinent because the number of renal transplantation patients has increased over the last two decades. As clinicians, is to facilitate and encourage them live life as normal as possible. There are only a few studies performed to address the safety of immune suppression, especially the novel immunosuppressive drugs, from the point of view of breastfeeding by a transplanted mother. This review is aimed to critically appraise current evidence to answer with a focus on immune suppression for renal transplantation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
