Breast-feeding after transplantation

Best Pract Res Clin Obstet Gynaecol. 2014 Nov;28(8):1163-73. doi: 10.1016/j.bpobgyn.2014.09.001. Epub 2014 Sep 16.


Transplantation affords recipients the potential for a full life and, for some, parenthood. Female transplant recipients must continue to take immunosuppression during pregnancy and breast-feeding. This article reviews case and series reports regarding breast-feeding in those taking transplant medications. Avoidance of breast-feeding has been the customary advice because of the potential adverse effects of immunosuppressive exposure on the infant. Subsequent studies have demonstrated that not all medication exposure translates to risk for the infant, that the exposure in utero is greater than via breast milk and that no lingering effects due to breast-feeding have been found to date in infants who were breast-fed while their mothers were taking prednisone, azathioprine, cyclosporine, and/or tacrolimus. Thus, except for those medications where clinical information is inadequate (mycophenolic acid products, sirolimus, everolimus, and belatacept), the recommendation for transplant recipients regarding breast-feeding has evolved into one that is cautiously optimistic.

Keywords: breast milk; breast-feeding; immunosuppression; lactation; transplant.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Breast Feeding*
  • Evidence-Based Medicine
  • Female
  • Guidelines as Topic
  • Humans
  • Immunosuppression Therapy* / adverse effects
  • Immunosuppression Therapy* / methods
  • Immunosuppressive Agents* / adverse effects
  • Immunosuppressive Agents* / analysis
  • Immunosuppressive Agents* / pharmacokinetics
  • Infant
  • Infant, Newborn
  • Milk, Human / chemistry
  • Milk, Human / immunology
  • Organ Transplantation*
  • Pregnancy
  • Risk Factors


  • Immunosuppressive Agents