To      :  Jane Kershaw
Re       :  Methotrexate

I would agree that methotrexate levels as published, are low to minimal in
milk.  However, there are numerous suggestions that methotrexate can become
concentrated in certain tissues and be retained in these compartments for
long periods of time (6 months).  One particular set of tissues are neonatal
GI, bladder and bone marrow of the neonate.

While we can "rescue" patients with a folic acid product (Leukovorin), I do
not think it would be practical to use it daily in a breastfeeding infant.

Sorry, but I would not generally recommend a mom use this product if at all
possible. If therapy were brief (few weeks), perhaps, but long-term
therapy...I would be very uncomfortable.

Regards
Tom Hale, Ph.D.