Adalimumab

Maternal adalimumab injections produce low levels in breastmilk. Because adalimumab is a large protein molecule, it is likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal.[1] Adalimumab was undetectable in the serum of some breastfed infants and adalimumab does not adversely affect the development of breastfed infants or increase the risk of infections. Anti-TNF agents appear to reduce the levels of tumor necrosis factor and IP-10 in the milk of mothers with inflammatory bowel disease in the early postpartum period.[2] Waiting for at least 2 weeks postpartum to resume therapy suspended during pregnancy may minimize transfer to the infant.[3] However, in infants of mothers who received adalimumab during late pregnancy, continued use while breastfeeding does not prolong adalimumab elimination by the infant.[4] Numerous experts and professional guidelines have stated that adalimumab is a low risk to the nursing infant and acceptable to use during breastfeeding.[5-11]