Is Interferon alfa compatible with breastfeeding? Do we have alternatives for Interferon alfa?

Interferon alfa

July 16, 2017 (Very Low Risk)

Alpha-Interferon is a cytokine with antiviral, antiproliferative and immunomodulatory properties with is produced by leukocytes and lymphoblasts that are obtained by recombinant DNA engineering. On various types (2a, 2b, N1, N3, etc.), it is indicated on the treatment of chronic hepatitis B and C, some neoplasms and leukemia. See also info on Alpha-Peginterferon.



In the form of interferon-gamma is naturally found in breastmilk (Goldman 1996) where it is produced by leukocytes from colostrum and mature milk (Lawton 1979); Probably it acts on the oropharyngeal and intestinal lymphoid tissue of the infant contributing to the development and maturation of the immune system (Bocci 1993).
Interferon gamma level is higher in premature mother's milk than in at-term mother's milk (Srivastava 1996, Moles 2015). Milk pasteurization reduces the interferon gamma level (Ewaschuk 2011).
Breastfeeding, probably through increasing prolactin, increases the maternal plasma concentration of interferon gamma and interleukin compared to baseline conditions (Shimaoka 2001).

High molecular weight of various interferons, a high binding capacity to T-lymphocytes and distribution outside the plasma compartment turns it very unlikely the pass into milk.
Due to protein nature, a low oral bioavailability is predicted after being digested by the intestine of infants. Therefore, infants' plasma levels from ingested breast milk must be zero or low (Cree 2013), except in preterm infants and immediate neonatal period (2 first weeks after birth), in which there may be greater intestinal absorption.
Interferons are relatively non-toxic and no adverse effects have been reported in breastfed infants (Almas 2016)



The excretion of interferon alpha-2B into breast milk is insignificant (Haggstrom 1996, Kumar 2000). No effects were reported in an infant whose mother was given Interferon Alfa 2B (Williams 1994).
Neither side effects have been observed in infants after maternal treatment for months or years with interferon beta (1A or 1B). (Hellwig 2011, Rockhoff 2012, Hale 2012, Fragoso 2013, Almas 2016).



Interferon administration does not affect prolactin production (Müller 1992)

S

Several scientific societies consider that interferon beta can probably be safely used during breastfeeding (Mahadevan 2006, Bove 2014, Bodiguel 2014).

The American Academy of Pediatrics considers alpha interferon as a medication usually compatible with breastfeeding.


See below the information of these related products:

Alternatives

We do not have alternatives for Interferon alfa since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • IFN-α
  • Interferon alfa-2a
  • Interferon alfa-2b
  • Interferon alfacon-1
  • Interferon alfa-n1
  • Interferon alfa-n3

Writings

  • إينتارفيرون ألفا (Arabic)
  • Интерферон Альфа (Cyrillic)
  • 干扰素α (Chinese)
  • インターフェロンアルファ (Japanese)
  • Ro-22-8181 (Experimental code/s)
  • Sch-30500 (Experimental code/s)

Drug trade names

References

  1. EMA. Interferón alfa-2b. Drug Summary. 2016 Full text (in our servers)
  2. Almas S, Vance J, Baker T, Hale T. Management of Multiple Sclerosis in the Breastfeeding Mother. Mult Scler Int. 2016Abstract Full text (link to original source) Full text (in our servers)
  3. Grunewald S, Jank A. New systemic agents in dermatology with respect to fertility, pregnancy, and lactation. J Dtsch Dermatol Ges. 2015Abstract Full text (link to original source) Full text (in our servers)
  4. Moles L, Manzano S, Fernández L, Montilla A, Corzo N, Ares S, Rodríguez JM, Espinosa-Martos I. Bacteriological, biochemical, and immunological properties of colostrum and mature milk from mothers of extremely preterm infants. J Pediatr Gastroenterol Nutr. 2015Abstract
  5. Bodiguel E, Bensa C, Brassat D, Laplaud D, Le Page E, Ouallet JC, Zephir H, De Seze J; Groupe de Réflexion sur la Sclérose en Plaques.. Multiple sclerosis and pregnancy. Rev Neurol (Paris). 2014Abstract
  6. Bove R, Alwan S, Friedman JM, Hellwig K, Houtchens M, Koren G, Lu E, McElrath TF, Smyth P, Tremlett H, Sadovnick AD. Management of multiple sclerosis during pregnancy and the reproductive years: a systematic review. Obstet Gynecol. 2014Abstract
  7. Fragoso YD, Boggild M, Macias-Islas MA, Carra A, Schaerer KD, Aguayo A, de Almeida SM, Alvarenga MP, Alvarenga RM, Alves-Leon SV, Arruda WO, Brooks JB, Comini-Frota ER, Ferreira ML, Finkelsztejn A, Finkelsztejn JM, de Freitas LD, Gallina AS, da Gama PD, Georgetto S, Giacomo MC, Gomes S, et al. The effects of long-term exposure to disease-modifying drugs during pregnancy in multiple sclerosis. Clin Neurol Neurosurg. 2013Abstract
  8. Rockhoff M, Hellwig K. Family planning and interferon (beta)-1b - A case report of successful hormonal stimulation, pregnancy and breast-feeding under interferon (beta)-1b Aktuel Neurol Suppl.1:S49-S51. 2012
  9. Hale TW, Siddiqui AA, Baker TE. Transfer of interferon β-1a into human breastmilk. Breastfeed Med. 2012Abstract
  10. Ewaschuk JB, Unger S, O'Connor DL, Stone D, Harvey S, Clandinin MT, Field CJ. Effect of pasteurization on selected immune components of donated human breast milk. J Perinatol. 2011Abstract
  11. Hellwig K, Gold R. Glatiramer acetate and interferon-beta throughout gestation and postpartum in women with multiple sclerosis. J Neurol. 2011Abstract
  12. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  13. Shimaoka Y, Hidaka Y, Tada H, Takeoka K, Morimoto Y, Amino N. Influence of breast-feeding on the production of cytokines. Am J Reprod Immunol. 2001Abstract
  14. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  15. Kumar AR, Hale TW, Mock RE. Transfer of interferon alfa into human breast milk. J Hum Lact. 2000Abstract
  16. Goldman AS, Chheda S, Garofalo R, Schmalstieg FC. Cytokines in human milk: properties and potential effects upon the mammary gland and the neonate. J Mammary Gland Biol Neoplasia. 1996Abstract
  17. Haggstrom J, Adriansson M, Hybbinette T, Harnby E, Thorbert G. Two cases of CML treated with alpha-interferon during second and third trimester of pregnancy with analysis of the drug in the new-born immediately postpartum. Eur J Haematol. 1996Abstract
  18. Srivastava MD, Srivastava A, Brouhard B, Saneto R, Groh-Wargo S, Kubit J. Cytokines in human milk. Res Commun Mol Pathol Pharmacol. 1996Abstract
  19. Williams JM, Schlesinger PE, Gray AG. Successful treatment of essential thrombocythaemia and recurrent abortion with alpha interferon. Br J Haematol. 1994Abstract
  20. Bocci V, von Bremen K, Corradeschi F, Franchi F, Luzzi E, Paulesu L. Presence of interferon-gamma and interleukin-6 in colostrum of normal women. Lymphokine Cytokine Res. 1993Abstract
  21. Müller H, Hiemke C, Hammes E, Hess G. Sub-acute effects of interferon-alpha 2 on adrenocorticotrophic hormone, cortisol, growth hormone and prolactin in humans. Psychoneuroendocrinology. 1992Abstract
  22. Lawton JW, Shortridge KF, Wong RL, Ng MH. Interferon synthesis by human colostral leucocytes. Arch Dis Child. 1979Abstract