Maternal transplantation medications during breastfeeding

Previously transplanted women have maintained successful pregnancies yet have been discouraged from breastfeeding. The American Academy of Pediatrics cautions against breastfeeding due to documented presence of cyclosporine in breast milk and unknown long-term effects on nursing infants. Transplant centers, however, report mothers breastfeeding with no measurable cyclosporine serum concentrations or untoward effects in their infants. Few data are available with regard to levels of other transplant medications in breast milk. Given the small number of published reports involving lactating women and relatively short follow-up of their infants, routine medication levels should be part of any screening regimen for such breastfed infants until further studies are available.