Question

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

Answer by DrLact: About Ceredase usage in lactation

Ceredase is a synthetic form of beta-glucocerebrosidase, which is a normal component of human milk. After therapeutic use of Ceredase, breastmilk levels are lower than those of normal mothers.[1] Additionally, absorption by the infant is unlikely because it is probably destroyed in the infant's gastrointestinal tract.[2][3] A limited amount of data support the safety of breastfeeding with Ceredase. 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 Ceredase or alglucerase (the placenta-derived 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.[3][4]

Ceredase Side Effects in Breastfeeding

One woman received alglucerase 30 international units/kg intravenously every 2 weeks during pregnancy and lactation. Her breastfed infant reportedly grew and developed normally.[7] A woman received Ceredase 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 Ceredase 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 Ceredase 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.[1] A woman with Gaucher's disease received Ceredase 1800 units (30 units/kg) every 2 weeks during pregnancy and postpartum. Her infant was breastfed (extent not stated) and was followed by a pediatrician who determined that development was normal over 2 years.[9]
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