Humira adalimumab 40 mg injection

[Martina]

One of my clients has colitis ulcerosa and also Bechterev. She uses humira adalimumab injections 40 mg.
She has heard she can't breastfeed when using the medication. She know wants to breastfeed the first 6 weeks and after that period she has to stop because she actually really needs this medication. I can't find anything on this medication. Is this known to you? Is it compatible with breastfeeding.
THank you in advance.

Martina Schippers

[cpride]

Dear Martina,

Adalimumab (Humira) is a recombinant humanized IgG1 monoclonal antibody. The drug is given either intravenously or intramuscularly because the oral bioavailability is low. Because of the decreased ability for the drug to be absorbed via the GI tract, the baby would have difficulty absorbing the drug via breastmilk. Also, IgG transfers into mature breastmilk rather poorly, and this IgG1 antibody would be even less likely to transfer. We do not, however, have data on the transfer of adalimumab into breastmilk. The colostral phase of breastmilk production is the exception to the poor transfer of this drug. During the colostral phase, the milk compartment is wide open. But once the mom's mature breastmilk has come in, usually at 5 to 7 days postpartum, the milk compartment that was wide open during the colostral phase closes, and adalimumab would then have difficulty entering breastmilk. Dr. Hale recommends that if the mother is using adalimumab during the first week postpartum, she should pump and discard until her mature milk is in. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN,CPNP
TTUHSC InfantRisk Center