Mothering Forum banner

1 - 19 of 19 Posts

·
Registered
Joined
·
20 Posts
Discussion Starter · #1 ·
I was diagnosed with rheumatoid arthritis five years ago and before becoming pregnant controlled it with Humira. During my pregnancy I experienced few symptoms and was able to stay off of medication. I was feeling great up until four weeks after I delivered. My daughter is seven weeks old now and the last three weeks have been incredibly difficult. I can barely walk at times and my husband has to put my baby in my arms at night so that I can feed her. I am in constant pain--it is a challenge to simply change her diaper. I desperately want to continue breastfeeding. It has been such a wonderful experience and I just hate the thought of putting her on formula and no longer being able to comfort her with my breast. The thought of not being able to nurse my daughter is devastating to me but I don't know how long I can continue to be in so much pain and am afraid I have not choice but to go back on Humira. I am currently on as much prednisone as my Rheumatologist says I can be on without it entering my breast milk, not to mention the Motrin I am taking daily. My doctor feels strongly that I should not breastfeed while on Humira because there has not been enough studies to determine the safety of it. This is killing me and I don’t know what to do. Does anyone out there have a similar experience or any advice?
 

·
Registered
Joined
·
8,849 Posts
have you thought or discussed with your Dr taking a theraputic dose of Cannabis?
 

·
Registered
Joined
·
42,824 Posts
A quick goggle showed at least one place where someone said it's safe. You need someone with a copy of Hale's to look it up for you.<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><br><br>
-Angela
 

·
Registered
Joined
·
643 Posts
This may not be the 'popular' opinion, but if the choice is between you being in constant pain and almost incapacitated or feeding formula and feeling well, I'd pick formula every time. This is one case, at least, where the 'risks' of formula are definitely outweighed by the benefits of not being in constant, chronic pain. I'm so sorry you are facing this decision! I hope you can figure something out.
 

·
Registered
Joined
·
1,808 Posts
Hale's says it's an L3, which isn't so good, but unlikely to enter milk in any clinically relevant amounts after the first week postpartum, but there aren't any actual studies on it. If you go to Amazon.com and search for "Medications and Mother's Milk" you'll find his book and then you can search inside the book. HTH.
 

·
Registered
Joined
·
231 Posts
Your rheumatologist (spelling?) is not qualified to determine whether the drug is appropriate for breastfeeding. I would discuss it with your pediatrician as well as an IBCLC, who can consult other MDs (maybe Hale himself?) as necessary. I take an anticonvulsant and was very worried about bf, my ped consulted with a pediatric neurologist and we decided it was ok. So don't make any decisions until you have all the information - the classification of the drug is not the whole story. And if for whatever reason, it does not work out, be proud of the amazing effort you put forth to nurse your little one thus far.
 

·
Registered
Joined
·
2,622 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>JessBB</strong> <a href="/community/forum/post/9056803"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Your rheumatologist (spelling?) is not qualified to determine whether the drug is appropriate for breastfeeding. I would discuss it with your pediatrician as well as an IBCLC, who can consult other MDs (maybe Hale himself?) as necessary. I take an anticonvulsant and was very worried about bf, my ped consulted with a pediatric neurologist and we decided it was ok. So don't make any decisions until you have all the information - the classification of the drug is not the whole story. And if for whatever reason, it does not work out, be proud of the amazing effort you put forth to nurse your little one thus far.</div>
</td>
</tr></table></div>
Totally agree with this post. Also Thomas Hale has a website with a forum for questions...<br><br><a href="http://neonatal.ttuhsc.edu/lact/medicationforumspage.html" target="_blank">http://neonatal.ttuhsc.edu/lact/medi...orumspage.html</a><br><br>
You may find that helpful. Totally second the LC advice though. You could also write to Dr. Jack Newman; he does answer emails from moms. <a href="http://www.drjacknewman.com" target="_blank">http://www.drjacknewman.com</a><br><br>
I'm so sorry that you are going through this, but it's likely that you can find a solution! Please don't rely on your doctor as your best source of breastfeeding information. It's just not what they do.
 

·
Registered
Joined
·
1,245 Posts
I think I'd choose formula. I'm faced with a similar decision. I suffer from daily migraines - when I say migraine it's more than just a "bad headache." We're talking nauseau, vomiting, flu-like symptoms, sensitivity to light, sound, everything. They are horrible and I can't stand it. Not to mention, I have two older kids that I homeschool and a 2 year old on top of the new baby. So far, I've tried all the "safe" drugs and none of them work. The only drug that comes even close to giving me relief is rated an L3/4.<br><br>
Just wanted to let you know you're not alone. I'm still bfing as he's only 3 weeks old and I'm just not ready to make a decision, but each day is such a constant struggle that I'm seriously leaning towards formula...
 

·
Registered
Joined
·
2,336 Posts
Marcy, I'm with you on the migraines. If I had them daily, I would be facing a hard choice. As it is, they are 1-2 times per week, and I have found that a mixture of Balacet and hydrocodone are the only things that can keep me functional. Midran (duradrin) was also a big help, but while my OB was comfortable prescribing it for me, my family doc isn't, so I'm deferring to him right now.<br><br>
Emmy'sMom, can you possibly ask for some donor milk through your FYT area or milkshare.org? If we lived close to one another, I would certainly pump for you.
 

·
Registered
Joined
·
1,820 Posts
Most La Leche League leaders should also have access to a copy of Hale, which is the best source of info on the topic.<br><br>
Once you have more complete information about the safety of the drug while nursing, please be gentle with yourself if it turns out that you have to wean. Formula is there for moms who truly can't breastfeed, and if you fall into this category, you don't need to feel guilty for using it. But I know it would be a great and painful loss, so I hope you are able to make something work.<br><br>
Goo dluck!
 

·
Registered
Joined
·
6,403 Posts
I don't see why you couldn't take Humira with breastmilk. I mean, the whole reason you have to inject it is that IT CAN'T BE ABSORBED ORALLY!!! So unless you're injecting the baby with your breastmilk, what on earth would be the mechanism of absorption?
 

·
Registered
Joined
·
6,403 Posts
p.s. My perinatologist and GI (I have Crohn's and am starting Humira next week) say that, obviously, there isn't a lot of data, but Humira is likely to have the same side effect profile in fetuses and babies as Remicade-- which is to say, no problems reported so far.<br><br>
p.p.s. Your baby isn't a fetus any more. Find and talk to a pediatric rheumatologist (who has probably prescribed Humira to babies or at least young children) about this issue, in conjunction with a regular ped, and get THEM to make a determination about what the risks are vs. the benefits, if you need that to get your rheumy off your back. IME peds are better-informed about breastfeeding than the typical rheumatologist/ GI/ whatever. I know my GI knows exactly as much about bf as the general public.
 

·
Registered
Joined
·
20 Posts
Discussion Starter · #14 ·
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>daniedb</strong> <a href="/community/forum/post/9068402"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;"><br>
Emmy'sMom, can you possibly ask for some donor milk through your FYT area or milkshare.org? If we lived close to one another, I would certainly pump for you.</div>
</td>
</tr></table></div>
That is so sweet! Thank you for the offer.<br><br>
Well, I emailed Jack Newman and he thinks Humira cannot enter breastmilk and even if it did, it would not bioavailable orally in the baby because it needs to be injected (as lolar2 said--good point!). His exact words were "There is absolutely no reason to worry about it". I also read about it on Tom Hale's discussion forum. He has done research on Remicade, which is similar, and found it did not enter breastmilk. He also feels it is safe. I am going to take all of this to my Rheumatologist on Friday and go from there. I am feeling much better about the situation. I can't thank you all enough for your help and encouragement.
 

·
Registered
Joined
·
3,591 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>daniedb</strong> <a href="/community/forum/post/9068402"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Marcy, I'm with you on the migraines. If I had them daily, I would be facing a hard choice. As it is, they are 1-2 times per week, and I have found that a mixture of Balacet and hydrocodone are the only things that can keep me functional. Midran (duradrin) was also a big help, but while my OB was comfortable prescribing it for me, my family doc isn't, so I'm deferring to him right now.<br></div>
</td>
</tr></table></div>
I'm with you too. I had them during pg and took opiate narcotics. People thought I was insane. But I'm sure you understand.
 

·
Registered
Joined
·
19,261 Posts
<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><img alt="" class="inlineimg" src="/img/vbsmilies/smilies/praying.gif" style="border:0px solid;" title="praying">: for you.<br><br>
I am going tomorrow to find out if I have RA myself. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> These issues have been floating around alot in my family right now too as I am breastfeeding Mylee and have been in a wheelchair 3 times this summer. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

·
Registered
Joined
·
493 Posts
I have Psoriasis and I'm in a similar situation WRT meds. My derm has done a phone consult with Dr. Hale, and was very confident after that conversation in prescribing Remicade or Enbrel while I am still nursing.<br><br>
Now I'm fighting with the insurance company, since they think I need to try methotrexate for several months before they'll pay for a biologic, but that's another story.
 

·
Registered
Joined
·
6,403 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>Meredith&Alexander</strong> <a href="/community/forum/post/9076836"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Now I'm fighting with the insurance company, since they think I need to try methotrexate for several months before they'll pay for a biologic, but that's another story.</div>
</td>
</tr></table></div>
Little trick from my GI: they are more likely to back down on the methotrexate if you say you plan to become pregnant in the next couple of years. Since biologics MAY cause birth defects (but never, apparently, have) and metho DOES cause miscarriage, it's no contest.
 

·
Registered
Joined
·
493 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>lolar2</strong> <a href="/community/forum/post/9077259"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Little trick from my GI: they are more likely to back down on the methotrexate if you say you plan to become pregnant in the next couple of years. Since biologics MAY cause birth defects (but never, apparently, have) and metho DOES cause miscarriage, it's no contest.</div>
</td>
</tr></table></div>
We tried that last time- it flares after I give birth, so we did this drill in 2003, too. My doc wrote volumes on why methotrexate was not an appropriate therapy for me, and the insurance company still refused to pay for a biologic. He told me they use it as a litmus test on how serious you are about getting treatment. Since psoriasis isn't serious enough to warrant treatment otherwise <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shrug.gif" style="border:0px solid;" title="shrug"> Yeah, walking around with 35% of my body an open sore is just a minor inconvenience.
 
1 - 19 of 19 Posts
Top