~~~~~~~~~~~~~~~~~~~~~~~~~~~
Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined.
John S. C. Abbot
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Ann asks about a form of heparin called Innohep:

<<If the molecular weight is still in the thousands would it be too large to
pass into milk anyway? I don't have any details on the specifics of this
drug right now>>

While I don't have info on the specific form you ask about, this is what I could find, from Clinical Therapy in Breastfeeding Patients by Tom Hale, he discusses Lovenox and Fragmin, as you noted, but these are also listed as "Low Molecular Weight Heparin", like that is also a trade name.  He says,
"Due to their large molecular weights, heparin and its low molecular weight derivatives, enoxaparin and dalteparin, do not transfer into human milk.  Further, they are not orally bioavailable and have not been found to produce side effects in breastfeeding infants."  The "low molecular weight" and
"high molecular weight" language is somewhat confusing, but he says of the two derivatives listed above, "low molecular fraction (2000-8000 daltons) of heparin.  Transfer into human milk is very unlikely due to large molecular weight and no oral bioavailability."  They also have a half-life of from
2,3 - 4.5 hours, relatively short.  From a conference session of his which I attended, I have these notes, "If a drug is higher molecular weight, when swallowed, it will be digested, not absorbed into plasma."  It sounds like Innohep is in the same category as these other two.  It would certainly be
worth a dialogue with the physician to see if this is the case and then share Dr. Hale's info.  It seems to me you could certainly extrapolate the information from the two noted to the other one if it falls in the same category,.  Some meds you are more concerned about if the baby receiving the milk
is a premie, but from this info, it doesn't appear the medication even gets into the milk.

Marsha


~~~~~~~~~~~~~~~~~~~~~~~~~~~
Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined.
John S. C. Abbot
~~~~~~~~~~~~~~~~~~~~~~~~~~~

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