PMID- 17261122
OWN - NLM
STAT- MEDLINE
DCOM- 20070515
LR  - 20220409
IS  - 1470-0328 (Print)
IS  - 1470-0328 (Linking)
VI  - 114
IP  - 4
DP  - 2007 Apr
TI  - Azathioprine and breastfeeding: is it safe?
PG  - 498-501
AB  - Traditionally, women receiving azathioprine have been discouraged from 
      breastfeeding because of theoretical potential risks of neonatal bone marrow 
      suppression, susceptibility to infection, and pancreatitis. The aims of this 
      study were to measure the concentration of 6-mercaptopurine (6-MP) in breast milk 
      of mothers receiving azathioprine and in the blood of their babies and to 
      investigate any immunosuppressive effects on the babies. Women receiving 
      azathioprine, who after appropriate counselling wished to breastfeed their 
      babies, were approached for inclusion in the study. Breast milk samples were 
      obtained from recruited women, and 6-MP levels were measured in each breast milk 
      sample. Haemoglobin level, white cell and platelet counts, and 6-MP and 
      6-thioguanine nucleotides (6-TGN) levels were measured in the respective neonatal 
      blood samples. Clinical signs of immunosuppression in the neonates were noted. 
      Thirty-one breast milk samples were collected from ten women. Low concentrations 
      of 6-MP (1.2 and 7.6 nanograms/ml, compared with therapeutic immunosuppressant 
      level of 50 nanograms/ml in serum) were detected in two breast milk samples 
      obtained from one woman. 6-MP was not detected in any of the other 29 samples. 
      6-MP and 6-TGN were undetectable in the neonatal blood. There were no clinical or 
      haematological signs of immunosuppression in any of the ten neonates. We conclude 
      that breastfeeding should not be withheld in infants of mothers receiving 
      azathioprine.
FAU - Sau, A
AU  - Sau A
AD  - Department of Obstetrics & Gynaecology, University Hospital Lewisham, London, UK. 
      ashis.sau@uhl.nhs.uk
FAU - Clarke, S
AU  - Clarke S
FAU - Bass, J
AU  - Bass J
FAU - Kaiser, A
AU  - Kaiser A
FAU - Marinaki, A
AU  - Marinaki A
FAU - Nelson-Piercy, C
AU  - Nelson-Piercy C
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20070125
PL  - England
TA  - BJOG
JT  - BJOG : an international journal of obstetrics and gynaecology
JID - 100935741
RN  - 0 (Immunosuppressive Agents)
RN  - E7WED276I5 (Mercaptopurine)
RN  - MRK240IY2L (Azathioprine)
SB  - IM
MH  - Azathioprine/*adverse effects/pharmacokinetics
MH  - *Breast Feeding
MH  - Female
MH  - Humans
MH  - Immunosuppression Therapy
MH  - Immunosuppressive Agents/*adverse effects/pharmacokinetics
MH  - Infant
MH  - Infant, Newborn
MH  - Mercaptopurine/*analysis
MH  - Milk, Human/*chemistry
MH  - Pregnancy
MH  - Risk Factors
EDAT- 2007/01/31 09:00
MHDA- 2007/05/16 09:00
CRDT- 2007/01/31 09:00
PHST- 2007/01/31 09:00 [pubmed]
PHST- 2007/05/16 09:00 [medline]
PHST- 2007/01/31 09:00 [entrez]
AID - BJO1232 [pii]
AID - 10.1111/j.1471-0528.2006.01232.x [doi]
PST - ppublish
SO  - BJOG. 2007 Apr;114(4):498-501. doi: 10.1111/j.1471-0528.2006.01232.x. Epub 2007 
      Jan 25.