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Low-molecular-weight heparin.
Indicated for the prevention of postoperative venous thromboembolism.
Intravenous or subcutaneous administration.
At the date of the last update, there was no available published data on its excretion in breast milk.
The high molecular weight of standard or unfractionated heparin and also of low molecular weight heparins makes their passage into breast milk in clinically significant amounts highly unlikely.
Furthermore, heparins are inactivated in the gastrointestinal tract, not being absorbed (practically zero oral bioavailability), which prevents the passage into plasma of the infant from ingested breast milk.
There has been virtually no excretion in breast milk of other low molecular weight heparins such as dalteparin (Richter 2001) and the absence of anticoagulant activity in plasma of infants breastfed by mothers treated with enoxaparin (Guillonneau 1996).
The risk of heparin-induced thrombocytopenia and osteoporosis is lower with low molecular weight heparins (Fuller 2013, Middeldorp 2011, Rath 2010).
Various medical societies, experts, and expert consensus consider the use of this medication safe during breastfeeding (Bates 2018 and 1997, Schaefer 2015, Fuller 2013, Yurdakök 2012, Rath 2010).