Crohn's Disease & Motherhood: Breastfeeding (Nursing or Pumping) and Medication

If you’ve followed along for a little while, I recently became a new mom. After years of struggling to conceive, undergoing fertility treatments and finally having success with IVF, I have done so much research and question asking about my body, my Crohn’s disease, it’s complications, and ramifications, and the medications I have taken and am currently taking.

Questions about medication and pregnancy

As a Crohn’s disease patient, I knew right from the start the medications I use to manage my disease could impact my ability to breastfeed, and I wanted to ensure my babies safety, first and foremost. When we started talking with doctors about getting pregnant, I asked a series of parallel questions about medication and pregnancy, and medication and breastfeeding. Here are some examples: 

1. Is my current primary medication (Remicade infusions) safe for pregnancy?
2. Could I stay on the medication for the entire pregnancy?
3. Is my current primary medication (Remicade infusion) safe for breastfeeding?
4. Are there any studies about the amount of medication that passes into breast milk or the effects of Remicade in breastmilk on babies?
5. Is there an amount of time after my infusion I would need to pump and dump my milk for my babies safety?

I asked the same questions about the other medications I take, those that help manage my Crohn’s disease, the extra-intestinal manifestations I experience regularly, my anti-depressants, and the vitamins and supplements I take too. I did a lot of my own research too, online, in some of the support groups I participate in online, and by asking other IBD moms I knew about the things they’d learned and would recommend too.

Moms with Crohn's and colitis need to do what's best for them

As with ANY new mom, IBD moms should choose what works best for themselves and their family when it comes to breastfeeding, pumping and bottle feeding, and/or formula feeding their babies. What I want to share is specific to my story, and my current treatment plan (mainly Remicade infusions, and oral azathioprine daily).

I wanted to breastfeed my daughter but knew that only time would tell if it was a journey we were going to take together. What I learned during my pregnancy is that my medications were safe for pregnancy and breastfeeding, that there was research on both that I felt comfortable with, and that I did not have to discard any of the milk I produced around the timing of my infusions. My breastfeeding story took a turn at the beginning when my daughter arrived 4.5 weeks prematurely and struggled to nurse. After about 6 weeks of struggle and trial and error, we learned that my baby thrived with bottle feeding, so I became an exclusive pumping mom.

Crohn's and challenges with breastfeeding

Because I’m not nursing, my biggest challenges with breastfeeding are based on my Crohn’s disease. First off, hydration is more than important, it’s critical. I get dehydrated faster than I used to, and because of my own absorption issues, I’ve been relying on oral rehydration solutions (like drip drop) to stay hydrated. My milk supply decreases when I’m not properly hydrated, and my stomach feels upset, so this is of key importance to my health, well being, and breastfeeding success.

Next, I have a surgical port due to my IBD treatments (I write more about that decision here), and for me, the placement of my port impacted my milk supply in that breast. I wish had known this could happen before I started breastfeeding because it was frustrating and emotional to learn in the early weeks postpartum. When my milk came in, it also impacted the placement of my port as my chest changed size and shape. 

Finally, and most important, was nutrition. Because there’s so much to say on that topic, I will write more in an upcoming article.  

I’d love to hear about the things you experienced or learned postpartum if you explored breastfeeding in the form of nursing or pumping. Please comment below!