Healthy for baby & mom
Breastfeeding is a natural and beneficial option for both mother and child. In addition to providing the infant with a perfect and digestible mix of fat, protein and vitamins, it also provides a unique benefit to children at risk of developing IBD.
Nursing or "lactating" also provides IBD benefits to you as a mom as well. It can help protect your body against IBD relapse. Breastfeeding has not been associated with an increased risk of disease flares, as some mothers might fear.
The World Health Organization and most doctors recommend exclusively breastfeeding your child for the first six months of his or her life, and then continuing to breastfeed in addition to adding solid foods through the second year of life. However, this is not possible for everyone, and that’s ok! Breastfeeding for any period of time may not be feasible for you due to your milk supply, medications, or other personal factors. The most important thing is that your baby is fed. As always, talk to your doctor about what is right for you and your newborn.
Misconceptions around IBD & breastfeeding
IBD lactation is shrouded with misconceptions. Many women fear that their IBD medications will harm their nursing child since the drug can be passed from the mother to the infant through her milk. This fear was so strong that a European study reported that at one time, 60% of women stopped their medications in the postpartum period as a result. However, most IBD medications excreted in breast milk are in very low concentrations that doctors consider safe for a newborn.
While you should always talk to your doctor before changing your medication strategy, we've created a table of the most common IBD medications and the standard healthcare recommendation for nursing mothers.
Medications during breastfeeding: safety concerns and recommendations
| Medication | Recommendations |
|---|---|
| Mesalamine (5-ASA) | Safe for Baby |
| Ciprofloxacin | Safe for Baby |
| Metronidazole | NOT Safe for Baby |
| Prednisone | Safe for Baby |
| Budesonide | Safe for Baby |
| 6-MP/Azathioprine | Safe for Baby |
| Methotrexate | NOT Safe for Baby |
| Cyclosporine | Safe with Monitoring of Infant Levels |
| Tacrolimus | Safe with Monitoring of Infant Levels |
| Infliximab | Safe for Baby |
| Adalimumab | Safe for Baby |
| Certolizumab Pegol | Safe for Baby |
| Golimumab | Safe for Baby |
| Vedolizumab | Safe for Baby |
| Ustekinumab | Safe for Baby |
| Risankizumab | Limited data; presumed safe for baby |
| Mirikizumab | Limited data; presumed safe for baby |
| Guselkumab | Limited data; presumed safe for baby |
| Ozanimod | NOT Safe for Baby |
| Etrasimod | NOT Safe for Baby |
| Upadacitinib | NOT Safe for Baby |
| Tofacitinib | NOT Safe for Baby |
In conclusion, we suggest that the use of 5–ASA, systemic corticosteroids, thiopurines or biologic therapies should not influence the decision to breastfeed. Alternately, breastfeeding should not influence the decision to use these medications. Breastfeeding should be avoided in women taking small molecules. For more details on medications and breastfeeding please download the LactMed App.
Breast may be best
If your doctor says it's safe for you to breastfeed your baby and it is possible for you to do so, we recommend that you do. In addition to providing health benefits for both your little one and yourself, it gives you and your baby an intimate way to bond with each other that can help bring the two of you even closer. That being said, a fed baby is best- breastfeeding is not for everyone, and the most important thing is that your baby is receiving nourishment, regardless of whether that is in the form of breastmilk or formula.