Question

I am a breastfeeding mother and i want to know if it is safe to use Sevelamer? Is Sevelamer safe for nursing mother and child? Does Sevelamer extracts into breast milk? Does Sevelamer has any long term or short term side effects on infants? Can Sevelamer influence milk supply or can Sevelamer decrease milk supply in lactating mothers?

Answer by DrLact: About Sevelamer usage in lactation

Because sevelamer is not orally absorbed, sevelamer does not reach the breastmilk or adversely affect the breastfed infant after maternal administration. A suspension of sevelamer has been added directly to breastmilk to lower the phosphorus concentration of milk. This could be a useful maneuver for breastmilk use in infants with renal impairment; however, clinical use has not been reported. In addition to lowering average phosphorus content by 65% to over 80%, the calcium content of breastmilk was reduced by almost as much and the casein content also decreased somewhat. With sevelamer hydrochloride, the chloride content increased by 60% and the pH changed from 6.8 to 7.8, although pH appears to rebound over time.[1][2] Addition of large amounts of sevelamer to artificial formula also lowers the copper, magnesium, manganese, potassium, sulfur and zinc concentrations by about 20%.[3] Similar reductions might occur with breastmilk.
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