Talk to your healthcare provider
For some medicines, there are clear recommendations on whether it is safe to breastfeed or not. However, in some cases, individual assessments must be made, where the specialist weighs up the benefits and risks. It is important that you and your rheumatologist discuss and make a plan for this during your pregnancy.
Based on international systematic reviews of medical research, we know that a number of anti-rheumatic drugs are safe for pregnant and breastfeeding women to take. These systematic reviews often provide information that conflicts with what is stated on the package leaflet that comes with the medicine.
The many benefits of breast milk are well known, which means that there should be sound clinical grounds for discouraging mothers from breastfeeding.
General overview of recommendations
Below is an overview of recommendations regarding breastfeeding for medicines typically taken by women with rheumatic disease. Please note that this is general advice only, and you must always discuss your own personal medication with your rheumatologist. The timing of when you should start taking your medicines after childbirth must also always be clarified with your specialist.
- IL inhibitors (anakinra, canakinumab, tocilizumab, ixekizumab, secukinumab, utekinumab, guselkumab, risankizumab): limited clinical data. Discuss with your rheumatologist.
- Imurel®: can be taken while breastfeeding depending on the dose. Discuss with your rheumatologist.
- JAK inhibitors: should not be taken while breastfeeding.
- Methotrexate: should not be taken while breastfeeding.
- Orencia®: limited clinical data. Discuss with your rheumatologist.
- Plaquenil®: can be taken while breastfeeding.
- Prednisolone®: doses of ≤20 mg/day can be taken while breastfeeding. At higher doses, it may be advisable to delay breastfeeding; discuss with your rheumatologist.
- Salazopyrin®: can be taken while breastfeeding, but not if the baby was born prematurely or has jaundice. Discuss with your rheumatologist.
TNF inhibitors (adalimumab, etanercept, certolizumab, golimumab, infliximab): can be taken while breastfeeding.