This Is MS Multiple Sclerosis Knowledge & Support Community

Posted: **Wed Dec 29, 2010 11:00 am**

Hi

Sorry I haven't been around in quite a while. I'm hoping you guys can help me. I'm 15 weeks pregnant and as it looks like this one is actually going to stick, I am trying to find out everything I can about Copaxone & breastfeeding. I have been told that my neuro won't prescribe it to me if I plan to feed but I am hoping to find out what info is out there. If there is evidence that is safe I would like to be able to present it to him so that he can make an informed decision rather than just go with the party line.

I won't take anything if it is not safe for the baby but I really do not want to be relapsing with a newborn if there is anything I can do to stop it.

Thanks very much.

George

Posted: **Wed Dec 29, 2010 11:20 am**

as far as I know there are no official studies on the topic. As the breastfeeding afforded me the same benefits that pregnancy did I enjoyed nursing with no needles.

Ann

Posted: **Wed Dec 29, 2010 4:38 pm**

Congratulations, MrsGeorge! I send you my very best wishes.

I'm sure that you know you will find MUCH information with a Google search of This Is MS, even at the sidebar entry under the "Modules" using the terms "Copaxone and breast-feeding."

In November I posted the following in response to someone else's question. You may find some of the information useful:

Just this week I received the winter 2010 issue of Momentum, the magazine from the National MS Society. Its cover story, "MS and Starting a Family," deals with many of your questions. I encourage you to find a copy (perhaps from your local NMSS office); their website, http://www.nationalmssociety.org/multim ... index.aspx does not yet have the winter issue posted. (I have not checked recently – the winter issue maybe posted by now.)
Although I do not agree with the premise that MS is an autoimmune disease (I think that in my case excess insulin initiates the MS cascade), and I found no improvement when taking the disease-modifying drugs, the article makes good points:

Page 26, "… none of the disease-modifying drugs, including Avonex, Betaseron, Rebif, Tysabri, and Copaxone, are approved for use during pregnancy. Though these drugs haven't been proven to increase birth defects or affect development in unborn babies, most doctors tell their patients to stop – not only during pregnancy but for several months before trying to conceive. Indeed, some animal studies have found a higher rate of miscarriage with the interferon-based MS drugs."

Page 27, "During pregnancy, the mother's body releases estrogen and other hormones that suppress her immune response so she doesn't reject the baby. This natural immunosuppressant effect puts MS into a very quiet state, especially during the third trimester."

Page 32, "The breastfeeding conundrum:… just as in pregnancy, doctors usually recommend staying off disease-modifying drugs while you breastfeed. (You can take steroids while nursing, however.) If you decide to stay off your med and breastfeed, there is some evidence that nursing might protect you. 'The protection afforded through breastfeeding can be as beneficial, or more so, than the immune-suppressant drugs,' said Elsie E Gulick, PhD, RN, FAAN, professor emeritus at the Rutgers University College of Nursing, Newark, N.J.

When she studied new mothers with MS, Dr. Gulick discovered that women who did not breastfeed were three times more likely to have relapses and mothers who breastfed during the first three months of their baby's life. In other research, 87% of women who didn't breastfeed had a relapse in the first two months after delivery, compared with only 36% of women who breastfed exclusively."

Posted: **Thu Dec 30, 2010 12:45 am**

Hi MrsGeorge,

MrsGeorge wrote:Sorry I haven't been around in quite a while. I'm hoping you guys can help me. I'm 15 weeks pregnant and as it looks like this one is actually going to stick, I am trying to find out everything I can about Copaxone & breastfeeding. I have been told that my neuro won't prescribe it to me if I plan to feed but I am hoping to find out what info is out there. If there is evidence that is safe I would like to be able to present it to him so that he can make an informed decision rather than just go with the party line.

I won't take anything if it is not safe for the baby but I really do not want to be relapsing with a newborn if there is anything I can do to stop it.

Thanks very much.

George

Congratulations on your pregnancy! If you search the board for breastfeeding, other people have recommended a book my Thomas Hale, PhD Pharmacologist called "Medications and Mothers' Milk."
http://www.ibreastfeeding.com/content/p ... w-hale-phd

He runs a forum that fields many questions on various medications and breastfeeding. Hopefully, you will be able to find the information you need there. http://neonatal.ttuhsc.edu/cgi-bin/disc ... ?pg=topics

You may also be interested in another website he runs called the Infant Risk Center. http://www.infantrisk.org/category/breastfeeding

NHE

Posted: **Mon Jan 03, 2011 9:33 pm**

here is the thread on copaxone if you haven't found it yet (It falls in the "other category" for meds. Enter the forum as a guest in order to read):

http://neonatal.ttuhsc.edu/discus/messa ... 1212086135

The conclusion: "Its a large molecule and is unlikely even enter milk. Wouldn't be orally bioavailable any."

Posted: **Wed Jan 05, 2011 10:24 am**

Congrats on your new family member.

And I'm so glad that NHE already posted the info on Thomas Hale. Remember that a neurologist is an expert on neurology -- but for information about your baby, and especially about breastfeeding, you'll get the most accurate information from a pediatrician, from lactation consultants, and best of all from someone like Thomas Hale -- a breastfeeding pharmacologist!

(And of course from other people with MS who have been there personally!)

I would also like to give you this link:

http://www.drjacknewman.com/help/Breast ... ations.asp

Dr. Jack Newman is easier to read than Dr. Hale. He's a pediatrician.

Your neuro means well but is pretty much always going to recommend against DMD's while breastfeeding. I used Rebif while nursing and I was going to a pediatrician who had lots of breastfeeding moms in his practice who were injecting interferon. I also know many people with MS who nursed and used DMDs.

But the big thing is to enjoy your baby. Best wishes!

Edited to add this Q&A I found, which echoes an answer above. (The stomach part makes a lot of sense -- if we could absorb interferon or copaxone orally, we 'd have a pill instead of needles!)

http://www.breastfeeding.com/breastfeed ... -safe.aspx

Re: Is Betaseron (taken for MS) safe to take while breastfeeding?

All interferons, (including Betaseron) are safe during breastfeeding. One factor that determines whether a drug gets into the mother's breast milk or not is the size of the molecule. Any molecule with a molecular weight of greater than 600 to 1000 won’t get into the milk. Because interferons have molecular weights that are much larger (Betaseron has a molecular weight of 22,000), there is no issue. Furthermore, even if some interferon did get into the milk, which is very unlikely, it would be destroyed in the baby's stomach. Another drug sometimes used for multiple sclerosis, glatiramer (Copaxone) is also safe during breastfeeding for the same reasons.

Jack Newman, MD, FRCPC | July 19 , 2010 4:07 PM

This Is MS Multiple Sclerosis Knowledge & Support Community

Copaxone & breastfeedin question

Copaxone & breastfeedin question

Re: Copaxone & breastfeedin question