Is LMWH Safe in Breastfeeding

Question

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

LMWH lactation summary

DrLact safety Score for LMWH is 1 out of 8 which is considered Safe as per our analyses.
A safety Score of 1 indicates that usage of LMWH is mostly safe during lactation for breastfed baby.
Our study of different scientific research also indicates that LMWH does not cause any serious side effects in breastfeeding mothers.
Most of scientific studies and research papers declaring usage of LMWH safe in breastfeeding are based on normal dosage and may not hold true for higher 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 LMWH usage in lactation

The high molecular weight of both standard or non-fractionated LMWH, and, so-called low molecular weight LMWH makes excretion into breast milk extremely difficult. Dalteparin has been shown not to be excreted into breast milk . In addition, LMWHs are inactivated in the GE tract where they are not absorbed which is reason to have a nil oral bioavailability. Absence of anti-clotting activity in breastfed infants has been shown after treatment of the mother with Enoxaparin. Risk of LMWH-induced Thrombocytopenia or Osteoporosis in the mother is lower with low weight LMWHs. Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding.

Answer by DrLact: About LMWH usage in lactation

Although LMWH itself has not been studied, low molecular weight LMWHs (e.g., dalteparin, enoxaparin) are not excreted into breastmilk in clinically relevant amounts. Because LMWH has an even higher molecular weight of 3000 to 30,000 daltons, it would not be expected to be appreciably excreted into breastmilk or absorbed by the infant. No special precautions are required.[1]