Breastfeeding and Urso
Manufacturers of drugs often state that their medication should not be used while breastfeeding. These statements do not normally arise following specific research but from the fact that no research has been conducted. In the absence of concrete information, pharmaceutical manufacturers protect themselves from litigation by using these broad statements. Sometimes we simply do not know what is safe to take and err on the side of caution.
A recent study in the Czech Republic (Vitek et al., 2010) did look at the use of a drug while breastfeeding: ursodeoxycholic acid (Urso, or UDCA), something most PSCers take. They studied a woman with Primary Biliary Cirrhosis (PBC) who developed severe pruritus (itching) and elevated serum bile acids 3 weeks after giving birth. She was given Urso in daily doses from 500mg (7.5mg/kg) up to 1500mg (25mg/kg) over the following 8 weeks. She continued on the higher dose of Urso for the next 8 weeks.
Vitek’s team found that the Urso treatment was associated with improved liver enzyme levels, reduced pruritus and reduced fatigue. They found “no effects on breast milk bile acid content”. They state that the “psychomotor development of the child was normal, and no apparent side-effects of the treatment were observed in either child or mother”. They conclude that breastfeeding while taking Urso lactation is safe.
Urso is widely used for the treatment of cholestasis in pregnancy, and is a naturally occurring bile acid. Only tiny amounts of Urso get into our circulation and it is doubtful that any clinically significant amounts get into breast milk. Based on the conclusion that Urso is safe to take while breastfeeding with PBC, it is reasonable to expect the same to hold true for PSC. Obviously it is important to discuss your medication with your liver specialist who knows your exact circumstances before making any decisions.
ReferencesVítek L, Zelenková M, Brůha R. Safe use of ursodeoxycholic acid in a breast-feeding patient with primary biliary cirrhosis. Dig Liver Dis. 2010 Dec;42(12):911-2. Doi:10.1016/j.did.2010.06.002 (article in press. Accessed 22 February 2011]
Want to know more?
- For a peer reviewed fully referenced database of drugs to which breastfeeding mothers may be exposed, check out the United States National Library of Medicine website, Lactmed. You type in the name of the drug your are interested in and it provides the results and associated research.
- Pregnancy and PSC