Nav: Home

Study finds certain drugs used to treat eye diseases excreted into human breast milk

September 13, 2019

Certain drugs used to treat retinal diseases are excreted into breast milk, raising possible safety concerns for developing infants, suggests a first-of-its-kind study led by St. Michael's Hospital in Toronto and published in Ophthalmology.

Ranibizumab and aflibercept are medications used to treat several retinal diseases. They contain an agent called anti-vascular endothelial growth factor (anti-VEGF), which blocks the eye's production of vascular endothelial growth factor (VEGF). VEGF is a protein that stimulates the development of blood vessels but is associated with retinal diseases in high quantities.

VEGF is present in breast milk and plays an important role in the development of an infant's digestive system. As a result, anti-VEGF drugs in a nursing mother raise concerns about possible adverse events in a developing infant if the drugs were to pass into breast milk and suppress VEGF.

"As retina specialists, we often tell our pregnant or nursing patients that there's a risk of a small amount of these drugs making its way into the breast milk, but we can't be sure," said Dr. Rajeev Muni, co-lead author, a vitreoretinal surgeon at St. Michael's and a project investigator at the hospital's Li Ka Shing Knowledge Institute.

"We don't want these patients to lose their vision so we make a decision, despite limited information."

Hoping to change this, Dr. Muni and Dr. Verena Juncal, co-lead author and a retinal fellow at St. Michael's, measured the concentrations of retinal medications in the breast milk of three lactating patients following injection of anti-VEGF therapy. Each patient represented a different scenario - one continued to breastfeed while receiving therapy, one discontinued breastfeeding, and one never started.

The team found that the drugs were excreted into the breast milk within the first couple days following injection, with a corresponding reduction in VEGF levels.

They also found that the amount of medication detected in the patient who continued to breastfeed was significantly lower than the other two patients, suggesting that the medication was constantly excreted and ingested by the infant.

"These results definitively show us that the drug reaches the breast milk," said Dr. Juncal. "We realize that some readers may question the small sample size, but if the drug reaches the breast milk in three patients, it'll reach in 30 patients because it's the same biological process."

As the first study to evaluate the presence of Health Canada approved anti-VEGF therapy in human breast milk, these results provide a resource for ophthalmologists and retina specialists counselling pregnant and nursing patients.

"I'm comforted knowing that other pregnant or nursing mothers with retinal diseases will have the information needed to make an educated decision about whether to consider nursing while receiving these medications," said Lisa, one of the three study participants, who didn't want to reveal her surname.

Next, the researchers hope to collaborate with a team of paediatricians to find out whether the drug passes from the breast milk through the infant's digestive system and into the blood stream.

"If we can measure the levels of these drugs in the infant's blood, we can figure out the exposure over a long period of time," said Dr. Muni. "That's what's really important here - the possible effect of these drugs on the infant over a long period of time."
-end-
Drs. Muni and Juncal would like to acknowledge their collaborators in the Department of Ophthalmology at the University of Calgary.

St. Michael's Hospital

Related Breast Milk Articles:

Breast milk may help prevent sepsis in preemies
Researchers at Washington University School of Medicine in St. Louis and Mayo Clinic in Rochester, Minn., have found -- in newborn mice -- that a component of breast milk may help protect premature babies from developing life-threatening sepsis.
New study associates intake of dairy milk with greater risk of breast cancer
Intake of dairy milk is associated with a greater risk of breast cancer in women -- up to 80% depending on the amount consumed -- according to a new study conducted by researchers at Loma Linda University Health.
Study: Difference in breast milk concentrations impacts growth up to age 5
In a new study, researchers at University of California San Diego School of Medicine confirmed the findings of previous pilot studies that found an association between human milk concentrations and infant weight and body composition.
Component of human breast milk enhances cognitive development in babies
CHLA investigators show that early exposure to a carbohydrate found in breast milk, called 2'FL, positively influences neurodevelopment.
Photoinitiators detected in human breast milk
Photoinitators (PIs) are compounds used in the ink of many types of food packaging.
Informal sharing of breast milk gains popularity among women, despite safety risks
Women who are unable to produce enough breast milk for their children are increasingly turning to 'mother-to-mother' informal milk-sharing, a potentially unsafe practice that is discouraged by the pediatric medical community, according to new research being presented at the American Academy of Pediatrics (AAP) 2019 National Conference & Exhibition.
Compound in breast milk fights harmful bacteria
A compound in human breast milk fights infections by harmful bacteria while allowing beneficial bacteria to thrive, according to researchers at National Jewish Health and the University of Iowa.
Breast milk analyses show new opportunities for reducing risk of childhood obesity
The composition of breast milk in normal weight mothers differs from that of overweight mothers, and variations in small molecule metabolites found in breast milk are possible risk factors for childhood obesity.
Breast milk as drug-delivery device
Treating sick babies with engineered breast milk could someday be a reality, according to an article in Chemical & Engineering News (C&EN), the weekly newsmagazine of the American Chemical Society.
Breast milk microbiome contains yeast and fungi: Do these benefit the infant?
Investigators have now shown that the breast milk microbiome contains fungi.
More Breast Milk News and Breast Milk Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Our Relationship With Water
We need water to live. But with rising seas and so many lacking clean water – water is in crisis and so are we. This hour, TED speakers explore ideas around restoring our relationship with water. Guests on the show include legal scholar Kelsey Leonard, artist LaToya Ruby Frazier, and community organizer Colette Pichon Battle.
Now Playing: Science for the People

#569 Facing Fear
What do you fear? I mean really fear? Well, ok, maybe right now that's tough. We're living in a new age and definition of fear. But what do we do about it? Eva Holland has faced her fears, including trauma and phobia. She lived to tell the tale and write a book: "Nerve: Adventures in the Science of Fear".
Now Playing: Radiolab

Uncounted
First things first: our very own Latif Nasser has an exciting new show on Netflix. He talks to Jad about the hidden forces of the world that connect us all. Then, with an eye on the upcoming election, we take a look back: at two pieces from More Perfect Season 3 about Constitutional amendments that determine who gets to vote. Former Radiolab producer Julia Longoria takes us to Washington, D.C. The capital is at the heart of our democracy, but it's not a state, and it wasn't until the 23rd Amendment that its people got the right to vote for president. But that still left DC without full representation in Congress; D.C. sends a "non-voting delegate" to the House. Julia profiles that delegate, Congresswoman Eleanor Holmes Norton, and her unique approach to fighting for power in a virtually powerless role. Second, Radiolab producer Sarah Qari looks at a current fight to lower the US voting age to 16 that harkens back to the fight for the 26th Amendment in the 1960s. Eighteen-year-olds at the time argued that if they were old enough to be drafted to fight in the War, they were old enough to have a voice in our democracy. But what about today, when even younger Americans are finding themselves at the center of national political debates? Does it mean we should lower the voting age even further? This episode was reported and produced by Julia Longoria and Sarah Qari. Check out Latif Nasser's new Netflix show Connected here. Support Radiolab today at Radiolab.org/donate.