This mom should most definitely take her cort enemas and mesalamine. You are quite right about the systemic absorption of steroid from the cort enema, it's minimal. Even if she were taking low dose oral steroids, breast feeding would not be contraindicated. To quote Tom Hale's book "Medications and Mother's Milk" (1997 ed.) "Doses of 80 mg/day [of prednisone] in mothers produce insignificant absorption in infant (<0.1% of dose). Probably not clinically significant." In regards to mesalamine, while it does share some chemical similarity to aspirin it is not an aspirin product and cannot cause Reye's syndrome. While there has been a report of diarrhea in the breast fed infant of a mother on oral mesalamine it is usually not a problem. I have given mesalamine products to both my breast feeding and pregnant ulcerative colitis patients without reservation. The systemic absorption of mesalamine from suppositories is likely to be neglible. I think this child would benefit more from a mom who's feeling well on cort enemas and mesalamine suppositories than one who is ill and dehydrated off the meds. Peter Salomon, MD,FACG