Breastfeeding on Imuran/Azathioprine

[Chrissy178]

Hi, I don't post that often but this is something I really wanted to ask about.

I have ulcerative colitis and for the past year have been taking Pentasa (mesalazine) and Imuran (azathioprine) which has managed to keep things under control after years of struggling with the condition. On the advice of my gastro doctor, I continued to take both drugs while pregnant with no issues, and I'm now 37+4 weeks.

I know Pentasa is safe to take while breastfeeding but I wasn't sure about azathioprine. Initially I looked online for information about breastfeeding while taking azathioprine and kept finding a lot of conflicting advice, with a lot of people saying not to as there wasn't a lot of research done on it, but there were also women who claimed to have breastfed their babies while taking it with no problems.

I went to a doctor's appointment today and asked about it, and she consulted this big medical book which said that very little of the drug passes through the breastmilk so is pretty much safe and recent research also seems to suggest it's safe, though she said it's up to me to weigh up the benefits and risks.

I really want to breastfeed if I can. I breastfed my DS (age 3) and I enjoyed the experience and the closeness and would love to have that again with DC2. Even if it's just for a month, I would love to have baby get the benefits from it if she can. But at the same time, if I have to formula feed, I'll be okay about doing so - a bit disappointed, but I want to do what's right by my baby.

I was wondering if there were any mums out there who breastfed while taking azathioprine or anything similar, and how it turned out? x

Lactmed toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT indicates it's fine.....quite a lot of research quoted. Hope you get some reassuring experiences from other mumsnetters, too :)

Thanks for the link, I didn't see that one. :)

There are a few drugs that are absolutely contraindicated in bfeeding, but not many, and they're mainly the powerful anticancer drugs. Dr Hale (as per tiktok's link) is the authority on this - I don't have the stats to hand, but in summary people who actually know about this (as opposed to random medics with Opinions, of whom there are quite a lot) say that the benefits of breastfeeding are assumed to outweigh the theoretical risks of adverse effects of maternal azathioprine.

I've fed three babies (not all at the same time!) while taking quite a high dose of azathioprine, and they're all healthy teenagers now. I'm happy for you to PM me if you want more reassurance.

No, it's not a link to Hale.

Oh sorry, I thought he was referenced on lactmed. My bad.

Thanks for that! I've heard of Dr Hale's name before but never actually looked it up. Glad things turned out okay, I figured that hearing other's experiences would help me feel more reassured about going for it. ^^; I take 100mg a day.

This is Hale's site : www.infantrisk.com/. He may well contribute to Lactmed in some way, frogs, or Lactmed may use his work :)

hi, I'm breastfeeding my son while on azathioprine and humira. no issues here! I spoke to various specialists (neonatal and adult focused) before my son was born and they all agreed that the benefits of breastfeeding way outweighed any theoretical risks from the medication. My DS is eighteen months old now, still breastfeeding and probably will be for some time!

I hope everything goes well for you! if you have any questions feel free to ask, I'll answer anything I can for you! :-)