To : Michelle
Re : Remicade (Infliximab)

I would concur with my colleague Frank Nice.

This new product is a large peptide monoclonal antibody that binds to Tumor
Necrosis Factor and thus reduces the consequences of an autoimmune syndrome
such as with ulcerative colitis, Crohns disease,  etc.  Do to poor oral
absorption, it must be administered IV.

As such its large molecular weight would largely preclude its entry into
human milk, and it is extremely unlikely that any would be absorbed or
survive the acid milieu in the stomach of the infant.

Although we have no breastfeeding data on this product at all, and the
manufacturer suggests to weight the risks, I think most of us can see that
the risks of not breastfeeding, probably outweight the risks of this
medication.

Regards

Tom Hale, Ph.D.
Associate Professor of Pediatrics

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