Enzymes which are able to hydrolyze proteins.
They are found in all living beings and are an important part of pancreatic enzymes.
They are orally used for gastrointestinal disorders and topically on wounds and burns. There is an increasing trend on type and therapeutic uses (Craik 2011).
At latest update relevant published data on excretion into breast milk were not found.
Because the small dose used and low plasma uptake of most topical dermatological preparations it is unlikely that significant amounts of it will pass into breastmilk.
Its high molecular weight turns further improbable any excretion into breastmilk.
Due to its protein nature, when orally taken it is digested by the infant’s intestine, hence its absorption and passage to plasma should be nil.
Few studies with low levels of evidence on oral use of protease to alleviate breast congestion have shown uneven results (ABM 2016, Mangesi 2016).
We do not have alternatives for Proteases since it is relatively safe.
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
- Πεπτιδάσες (Greek)
- 프로테아제 (Korean)
- プロテアーゼ (Japanese)
Drug trade names
- Mangesi L, Zakarija-Grkovic I. Treatments for breast engorgement during lactation. Cochrane Database Syst Rev. 2016Abstract
- Berens P, Brodribb W. ABM Clinical Protocol #20: Engorgement, Revised 2016. Breastfeed Med. 2016Abstract Full text (link to original source) Full text (in our servers)
- Academy of Breastfeeding Medicine. Protocolo Clínico de la ABM #20, revisión 2016: Congestión Mamaria. Breastfeed Medicine. 2016Abstract Full text (link to original source) Full text (in our servers)
- Craik CS, Page MJ, Madison EL. Proteases as therapeutics. Biochem J. 2011Abstract
- Academy of Breastfeeding Medicine. Protocolo Clínico de la ABM #20, revisión 2009: Congestión Mamaria. Breastfeed Med. 2009 Full text (in our servers)