Jacque,

Hale classifies it as an L4 - Possibly hazardous. He states there are no studies available on its transfer to human breast milk. The manufacturer advises against its use. The molecular weight is very large and the amount in breastmilk is expected to be exceptionally low, per Hale. He goes on to say that there are no long term data on the safety of using this type of drug in breastfeeding mothers. He also includes this statement: "Furthermore, there are current data that suggest that some monoclonal antibody drugs do transfer into milk, and perhaps the breastfed infant. Therefore, some caution is recommended and each woman should understand the benefits and risk of using this type of medication."

Cindy Garrison BS IBCLC

Date: Fri, 21 May 2021 11:40:43 +1200
From: Jacquie Nutt <[log in to unmask]>
Subject: denosumab

Hello everyone

Is there anyone who knows of a mother having denosumab subcutaneously and
breastfeeding an older baby (this one is a 10 month old.) This 2021
information implies that there is little theoretical risk, but no evidence
at all. Concern is mostly for prem babies and newborns.

https://www.ncbi.nlm.nih.gov/books/NBK500588/#:~:text=Until%20more%20data%20become%20available,immunoglobulin%20G2%20(IgG2)%20antibody
.

The mum is distraught at being told to wean but she is at risk of losing
her leg due to a giant cell tumour of the knee. She's putting off the
treatment, which is bad because the tumour is growing and destroying her
bones.

Best wishes
Jacquie Nutt IBCLC

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