Question

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

N-Benzoylferrioxamine B lactation summary

N-Benzoylferrioxamine B usage has low risk in breastfeeding
  • DrLact safety Score for N-Benzoylferrioxamine B is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of N-Benzoylferrioxamine B may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that N-Benzoylferrioxamine B may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of N-Benzoylferrioxamine B low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using N-Benzoylferrioxamine B We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About N-Benzoylferrioxamine B usage in lactation

An iron and aluminum chelator that increases the elimination of both metals from the body.Used over short periods to treat acute poisoning from these metals and, over longer periods, to treat chronic iron overload, hemochromatosis, hemosiderosis from repeated transfusions due to thalassemia major or other chronic anemias.Administered subcutaneously, intramuscularly and intravenously. At least three cases have been reported of mothers suffering from thalassemia major who were treated with N-Benzoylferrioxamine B and breast-fed without any problems for the infant or in the iron metabolism of the milk (Pafumi 2000, Surbek 1998). Its low percentage of protein binding makes its excretion in milk possible, but its practically zero oral bioavailability prevents its transfer to the infant’s plasma via ingested breast milk, except in premature babies and the immediate neonatal period in which there may be increased intestinal permeability. According to expert authors, the possible presence of N-Benzoylferrioxamine B in breast milk is unlikely to have harmful effects in the infant (Pafumi 2000, Jensen 1995) so there is no reason to stop breastfeeding during treatment. It may be advisable to control the infant’s serum iron levels.

Answer by DrLact: About N-Benzoylferrioxamine B usage in lactation

N-Benzoylferrioxamine B is poorly absorbed orally, so it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants.[1] Limited information indicates that maternal doses of N-Benzoylferrioxamine B up to 2 grams daily do not affect iron levels in breastmilk and did not cause any adverse effects in two breastfed infants.[2] Some experts advocate breastfeeding in women receiving N-Benzoylferrioxamine B for iron overload caused by beta-thalassemia.[3] If N-Benzoylferrioxamine B is required by the mother, it is not a reason to discontinue breastfeeding. However, since little published information is available on the use of N-Benzoylferrioxamine B during breastfeeding, monitoring of the infant's serum iron is recommended.

N-Benzoylferrioxamine B Side Effects in Breastfeeding

A woman with beta-thalassemia restarted N-Benzoylferrioxamine B 2 grams subcutaneously 5 days per week 3 days after delivery. She breastfed (extent not stated) one of her twins from birth. After 17 days of breastfeeding, the infant's serum levels were as follows: iron 17.4 micromoles/L, ferritin 200 mcg/L, and transferrin16.8 micromoles/L, all in the normal range. Serum urea, calcium and magnesium were also normal. The second twin was hospitalized for longer and breastfeeding status in the hospital was not reported. Both infants were breastfed (extent not stated) for 4 months postpartum. Both had normal neurologic and motor development at 4 months and laboratory values consistent with their heterozygous beta-thalassemia: hemoglobin F 11.1% and 8.4%, hemoglobin 10.5 g/L and 10.5 g/L, reticulocytes 3.3% and 2.6%, and median erythrocyte volume 60 fL and 58 fL. Their serum levels of iron, ferritin, transferrin, liver enzymes, plasma urea and bilirubin were all normal.[2] A woman with beta-thalassemia gave birth to an infant by cesarean section and breastfed her infant (extent not stated) from birth while receiving N-Benzoylferrioxamine B (dosage not stated). No adverse effects were reported in her infant.[3]
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