Enbrel and breastfeeding - experiences please :-)

Hi there, my first post here! I'm 37yrs old, have had RA since I was 24yrs. Came off of my Enbrel when concieving my first son and when pregnant, and went back on it when he was 2months old as I had a post-partum flare and he was difficult to breastfeed anyway and went onto bottles so I could go back on meds. I then stopped the medication when conceiving 2nd son, and when pregnant. He is now 7months old and I am flaring badly. He is fully breastfed and my specialist nurse has ordered my Enbrel and all I need to do is call her when he is onto bottles. BUT, he does not want to take a bottle, AND I don't want to stop breastfeeding (several reasons but that's a whole different story). The thing is, I have researched and although Wyeth Pharmaceuticals won't endorse the use of Enbrel for pregnant or nursing mums, the facts are that the protein molecules in the drug are too large to pass through to the breast milk AND even if they did digestive enzymes in the baby's tummy would render them ineffective and harmless - this is why Enbrel has to be administered as an injection. What to do? I can call my Nurse tomorrow and ask if I can have the Enbrel and continue nursing, but I know she's not allowed to say yes - or is she, provided I take responsibility? The alternative is to be underhand and tell her he is now on bottles and just take the Enbrel anyway - but that's not really the sort of person I am plus I like and respect her so it feels wrong.

Has anyone on here been in this position, and been allowed to take a biological when breastfeeding? I can find a tonne of Americans who have, but I know thats kind of meaningless as their system is so different.

Thanks in advance :-)

4 Replies

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  • Hi!

    Welcome to Health Unlocked!

    I have four children all conceived prior to my starting Enbrel so can't offer thoughts from my own experience of this! I also haven't come across any friends who have continued on biologics or certain DMARDS whilst breastfeeding.

    However, on a purely ethical front, I think I would be guided by Wyeth's own advice. They will have researched their product to an extent that we are not aware of and clearly do not feel it appropriate to endorse the use of Enbrel for nursing mums.

    I know this isn't what you want to hear but I feel it would be foolhardy to go against their advice. Whatever reasons you have for breastfeeding should not overshadow your need for RA drugs. Whilst the RA is uncontrolled (as it is in a flare) you run the risk of long term joint damage. A high price to pay when you have small children to consider.

    Your relationship with your nurse is an important one for your long term health and I would definitely be inclined to take on board her thoughts on this. I had one baby who wasn't keen to take bottles but we got there with tears and perseverance!!

    Good luck, hope the RA is under control soon and baby is soon hooked on bottles :)

    Lyn x

  • Hi there, I have not had any experience in this as I only have one child who is 16 now!. I can only echo what Lyn above as said to you and that is to take advice from the drug company's guidelines, your RA needs to be under control to be able to cope with small children I know I've been there myself.

    One day your baby will have to come off the breast and start on bottles so you may as well do it now while the time is right for you and your treatment, you need to look after yourself too by taking the Enbrel, I myself wouldn't go against the drug company's advice.

    Take care and good luck with your decision.

    Mandy xx

  • the research available indicated that the drug gets through to the breast milk when tested on animals.. no trials on humans to my knowledge

  • I agree with the other ladies with regard to Embrel and breastfeeding, ultimately it is far better for your child if you are well and able to care for them longer term than putting yourself through a potentially damaging situation now. My children are 8 and 4 and I really struggle to get through the day sometimes and my RA is fairly under control. I suggest you persevere with the move to bottles and get yourself back on the drugs!

    Have you tried your baby on different types of bottles or cups? There are all sorts of different style bottles which claim to be closer in shape, texture and flow to breast. Soft spout cups might be worth a try? Also it seems that fast flow teats work better as baby does have to use different muscles to suck a bottle and may get frustrated if his/her usual breast technique doesn't produce the milk quick enough! Are you able to express and freeze your breast milk? If you could use breast milk in a bottle/cup and gradually mix breast and formula milk together it might make baby accept it as it's more familiar? Does your baby eat solid food well? It might be that s/he will be cutting down on the amount of milk/feeds soon anyway so it'll be less of a struggle with the bottles!

    There are some useful hints and tips about this subject on Netmums.com which may be worth a look at. Finally, can you talk to your Health Visitor about it? I know some are more helpful than others when it comes to this issue but there may be some new advances in bottles/approach that I'm unaware of as it was 4 years ago that I last breastfed a baby (where did that time go?!)

    Best of luck, it's going to be tough but the results will be worth it! Hope you are feeling better soon, keep us posted xx

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