Last update July 17, 2022
Very Low Risk
A human monoclonal antibody which inhibits the interleukin 6 (IL-6) receptor used in the treatment of rheumatoid arthritis, some forms of juvenile arthritis and in Castleman's disease. Intravenous administration every 4 weeks. Its use is authorized in Pediatrics from 2 years of age. Used experimentally in the treatment of the COVID-19 coronavirus. (Alzghari 2020, SEFH 2020)
Its very high molecular weight explains the minute transfer to breastmilk which has been observed (Saito 2021, 2019 & 2018, Moriyama 2020). The maximum concentration in milk occurs on the third day and is so low (68 to 148 nanograms/L), that the relative dose that day would be a maximum of 0.007%. (Saito 2018)
Its low oral bioavailability suggests that transfer to the infant's plasma from ingested breastmilk is nil or insignificant (Witzel 2014), except in premature infants and the immediate neonatal period, when there may be greater intestinal absorption.
Plasma levels in a breastfed infant were undetectable or very low, even in the neonatal period (Saito 2019).
No clinical, developmental or immunization (vaccines) problems have been observed in infants whose mothers were taking it during the first 9 to 12 months of life. (Saito 2021, 2019 y 2018, Salonga 2018, Nakajima 2016)
Several medical associations, experts and expert consensus consider the use of this medication to be compatible or probably compatible during breastfeeding (Jorgensen 2022, Sammaritano 2020, Briggs 2017, Götestam 2016) if there are no other safer options available.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Asociación Española de Bancos de Leche Humana of Spain
Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM