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Enzymes which are able to hydrolyze proteins.
They are found in all living beings and are an important part of digestive enzymes: pancreatic (trypsin and chymotrypsin) and gastric (pepsin)..
They are orally used for gastrointestinal disorders and topically on wounds and burns. Some (chymotrypsin) are used in cataract surgery.
There is an increasing trend on type and therapeutic uses (Craik 2011). There is no evidence of its efficacy in the treatment of post-traumatic or post-surgical inflammations or in respiratory diseases.
At latest update relevant published data on excretion into breast milk were not found.
Because the small dose used and low plasma uptake of most topical dermatological and ophthalmological preparations it is unlikely that significant amounts of it will pass into breastmilk.
Its high molecular weight turns further improbable any excretion into breastmilk.
Due to its protein nature, when orally taken it is digested by the infant’s intestine, hence its absorption and passage to plasma should be nil.
The manufacturer considers it compatible with breastfeeding (AEMPS 2016).
Few studies with low levels of evidence on oral use of proteases to alleviate breast congestion have shown uneven results (ABM 2016, Mangesi 2016).