Title

Breast-feeding after transplantation

Authors

Authors

S. Constantinescu; A. Pai; L. A. Coscia; J. M. Davison; M. J. Moritz;V. T. Armenti

Comments

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Abbreviated Journal Title

Best Pract. Res. Clin. Obstet. Gynaecol.

Keywords

immunosuppression; breast-feeding; transplant; breast milk; lactation; BIRTH-WEIGHT INFANTS; INTENSIVE-CARE-UNIT; HUMAN-MILK; FOLLOW-UP; NECROTIZING ENTEROCOLITIS; ANTENATAL CORTICOSTEROIDS; MYCOPHENOLATE-MOFETIL; BIOACTIVE FACTORS; RANDOMIZED-TRIAL; TACROLIMUS; Obstetrics & Gynecology

Abstract

Transplantation affords recipients the potential for a full life and, for some, parenthood. Female transplant recipients must continue to take immunosuppression during pregnancy and breast-feeding. This article reviews case and series reports regarding breast-feeding in those taking transplant medications. Avoidance of breast-feeding has been the customary advice because of the potential adverse effects of immunosuppressive exposure on the infant. Subsequent studies have demonstrated that not all medication exposure translates to risk for the infant, that the exposure in utero is greater than via breast milk and that no lingering effects due to breast-feeding have been found to date in infants who were breast-fed while their mothers were taking prednisone, azathioprine, cyclosporine, and/or tacrolimus. Thus, except for those medications where clinical information is inadequate (mycophenolic acid products, sirolimus, everolimus, and belatacept), the recommendation for transplant recipients regarding breastfeeding has evolved into one that is cautiously optimistic. (C) 2014 Elsevier Ltd. All rights reserved.

Journal Title

Best Practice & Research Clinical Obstetrics & Gynaecology

Volume

28

Issue/Number

8

Publication Date

1-1-2014

Document Type

Article

Language

English

First Page

1163

Last Page

1173

WOS Identifier

WOS:000346212700006

ISSN

1521-6934

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