Question

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

Answer by DrLact: About Glucocerebrosidase usage in lactation

Glucocerebrosidase is the placenta-derived form of the enzyme, beta-glucocerebrosidase which is a normal component of human milk. Studies with alclucerase and synthetic forms of the enzyme have found very low levels of the enzyme in breastmilk. Absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract.[1][2] A limited amount of data support the safety of breastfeeding with Glucocerebrosidase. An international panel of clinicians from 9 centers that treat Gaucher's disease reported that, breastfeeding complications were less frequent in mothers who were treated with Glucocerebrosidase or imiglucerase (the biosynthetic form of the enzyme) postpartum than in untreated mothers with Gaucher's disease. Consider limiting the duration of breastfeeding to about 6 months to avoid excessive bone loss in the nursing mother.[2][3]

Glucocerebrosidase Side Effects in Breastfeeding

One woman received Glucocerebrosidase 30 international units/kg intravenously every 2 weeks during pregnancy and lactation. Her breastfed infant reportedly grew and developed normally.[7] A woman received imiglucerase 30 units/kg every 2 weeks during pregnancy and for 3 months while breastfeeding. The dose was then increased to 60 units/kg every 2 weeks because of disease progression, and she continued breastfeeding until the infant was 1 year old.[8] A woman receiving long-term therapy with imiglucerase 60 units/kg intravenously every 2 weeks became pregnant twice during therapy and breastfed both infants (extent not stated). Both infants developed normally during the observation periods of 13 and 33 months.[5] A woman with type 1 Gaucher's disease was exclusively breastfeeding her infant postpartum re-initiated intravenous imiglucerase 30 units/kg every 2 weeks beginning at 1 month postpartum. The infant was breastfed for about 9 months postpartum and was reportedly healthy when followed up to 3 years of age.[6]
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