Breastfeeding and Mesalamine

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perach
Regular Member


Date Joined Apr 2007
Total Posts : 116
   Posted 8/22/2009 9:44 AM (GMT -6)   
I know that there are women on this board who are/have been breastfeeding while taking mesalamine.  I am due in a few weeks and have not been able to taper off of Lialda and stay healthy.  I understand that the risk to the baby is diarrhea and that if we see that I can decide to stop the Lialda or switch to formula.  If anyone could share their experience and also the dosages they are on, I would really appreciate it.  I currently take 4 Lialda a day and tried to taper down to two but went back up immediately once I starting seeing symptoms of a flare.  Thanks in advance for your responses!

-Lialda (4 pills/day), Align probiotic, multivitamin, calcium with vitamin d, iron


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/22/2009 10:13 AM (GMT -6)   
There's a link to an article in the "sticky" thread (the one that stays at the very top of the page called UC Resources) that covers IBD and Pregnancy. It's the last post in the thread. There is a section in this article that covers breastfeeding.

I honestly wouldn't take the risk of stopping the Lialda. I began my first flare about 4 weeks after having my son (he was born in mid October and symptoms started in mid November), but I wasn't diagnosed until the end of January. I got so sick that by about 8-9 weeks postpartum I lost my supply. It's also extremely hard to function, much less enjoy your newborn, in that situation. So, just remember it's more important to keep your UC under control, even if that means formula feeding, than it is to breastfeed your baby!
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


perach
Regular Member


Date Joined Apr 2007
Total Posts : 116
   Posted 8/24/2009 8:06 PM (GMT -6)   
Thanks for the advice Fruitgirl. I totally agree that controlling my UC needs to be a priority, if I end up in a severe flare I'm no good to anyone, let alone a newborn! I just wish there was more definitive research regarding breastfeeding and mesalamine. I guess I have little choice but to see whether the baby can handle it and then switch to formula if I see the baby has diarrhea.
-Lialda (4 pills/day), Align probiotic, multivitamin, calcium with vitamin d, iron


songlady
Veteran Member


Date Joined Aug 2009
Total Posts : 3694
   Posted 8/24/2009 8:34 PM (GMT -6)   
You might be lucky and have it all work out. I breastfed my two kids while on azulphidine (the first child) and asacol (the second child) without any issues (and my second kid didn't totally give up on the nursing until he was 3!) So - the best thing would be to learn what you can and just see how it all plays out. I wish you the best of luck!
Diagnosed UP 1983, Azulphidine
Diagnosed UC 1986 Prednisone almost 2 years
Asacol - 16 pills a day
Metamucil - 2 doses a day
Cortenemas or Rowasa from time to time
VSL#3, Ultimate Flora Critical Care
Canasa as needed


perach
Regular Member


Date Joined Apr 2007
Total Posts : 116
   Posted 8/25/2009 5:48 AM (GMT -6)   
Thanks so much Songlady, that is really what I hope happens. Can I ask what dosage of asacol you were on when you nursed successfully?
-Lialda (4 pills/day), Align probiotic, multivitamin, calcium with vitamin d, iron


quincy
Elite Member


Date Joined May 2003
Total Posts : 30984
   Posted 8/25/2009 3:18 PM (GMT -6)   
please consider to add rectal meds to your med regimen....


q
*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


perach
Regular Member


Date Joined Apr 2007
Total Posts : 116
   Posted 8/26/2009 10:11 AM (GMT -6)   
Quincy-I am a big believer in rectal meds, but have been able to maintain remission on only Lialda.  If I were to see any issues I would definitely bring them back.  Thanks!
-Lialda (4 pills/day), Align probiotic, multivitamin, calcium with vitamin d, iron


fruitgirl
Veteran Member


Date Joined Feb 2009
Total Posts : 7150
   Posted 8/26/2009 10:16 AM (GMT -6)   
But, perach, there's a LOT of evidence showing that people who use mesalamine enemas at a maintenance dose of two per week (I do mine on Thursday and Sunday) stay in remission for longer periods of time than those who don't. AND, you might be able to decrease the dose of your Lialda a bit if you add in the rectal meds.
Status: Remission since May 2009!
Symptoms began in November 2008, ~4 weeks after giving birth to my son.
Diagnosed with pancolitis on 1/30/09
Currently meds: Apriso (4 0.375g pills ONCE!! daily), mesalamine enema twice weekly, Natural Factors Ultimate probiotic 12/12 Formula, and Zoloft (currently tapering; 12.5 mg).


NiRo
Regular Member


Date Joined Aug 2009
Total Posts : 198
   Posted 8/26/2009 10:27 AM (GMT -6)   
fruitgirl - not that I dont believe you, but do you have any links supporting that? I would like to read the studies if at all possible...thx!
Lialda 4x a day (2x in the morning, 2x at night)
Rowasa Enema 1x at night
Align (Probiotic) 1x a day
Fish Oil 4x a day
Multi-Vitamins (includes B-12, Vitamin D, Vitamin C) 1x a day
Diagnosed with Pancolitis (Moderate in 4/5th of the colon, Mild in 1/5th) in July 2009


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5190
   Posted 8/26/2009 12:45 PM (GMT -6)   
NiRo-- go to gastroendonews.com -- you have to register briefly to use, but it's free. Look at Dr. Ellen Scherl's article on UC concerning 5-ASA responders. (Part 1). You can find the citation there to clinical studies supporting concurrent use of oral & rectal 5-ASA meds to maintain remission. / Old Hat (30 yrs with left-sided UC ... [etc.])

NiRo
Regular Member


Date Joined Aug 2009
Total Posts : 198
   Posted 8/26/2009 1:17 PM (GMT -6)   
Thanks Old Hat - great read and great site! Also apologies for going off topic...
Lialda 4x a day (2x in the morning, 2x at night)
Rowasa Enema 1x at night
Align (Probiotic) 1x a day
Fish Oil 4x a day
Multi-Vitamins (includes B-12, Vitamin D, Vitamin C) 1x a day
Diagnosed with Pancolitis (Moderate in 4/5th of the colon, Mild in 1/5th) in July 2009


quincy
Elite Member


Date Joined May 2003
Total Posts : 30984
   Posted 8/26/2009 1:32 PM (GMT -6)   
perach...you are on the highest dosage of lialda....it would be best to use the rectal meds at a maintenance dosage and then lower the Lialda.

you can up it if needed, but in truth, the first part to flare would be the rectum and many times it's not noticable until more apparent. If you are to lower the Lialda, lower it by one pill every few weeks.

It's easier to maintain above the sigmoid with a lower dosage of meds and deal with the lower part with a higher dosage.

You could also try the 2g dosage of rectal meds instead of 4.

quincy
*Heather* Status: ...Asacol 3 twice daily; Salofalk enemas every 3rd night
~diagnosed January 1989 UC (proctosigmoiditis)
~UC meds: Asacol (3 @ 2x daily); Salofalk enemas nightly for flares & taper to maintenance 
~Bentylol (dicyclomine) 20mg as needed; Ranitidine (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma) 
~vitamins/minerals/supplementsProbiotics....(RenewLife Ultimate Flora Critical Care + Primadophilus Reuteri). @ bedtime
~various digestive enzymes as needed
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


perach
Regular Member


Date Joined Apr 2007
Total Posts : 116
   Posted 8/26/2009 3:11 PM (GMT -6)   
Quincy-thanks for these thoughts. I will definitely discuss your suggestions with my gastroenterologist.
-Lialda (4 pills/day), Align probiotic, multivitamin, calcium with vitamin d, iron

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