From the Guidelines
Lovenox (enoxaparin) is safe for use during breastfeeding, as it has a low risk of passing into breast milk and being absorbed by the infant. The medication's large molecular size and negative charge limit its excretion into breast milk, and even if small amounts are present, the infant's digestive system would poorly absorb it 1.
Key Points
- The active ingredient in Lovenox is a large molecule that does not significantly pass into breast milk.
- Even if small amounts of Lovenox are present in breast milk, they would be poorly absorbed by the infant's digestive system due to limited oral bioavailability.
- Clinical experience and studies have shown no adverse effects in breastfed infants whose mothers are taking Lovenox 1.
- Lovenox is often preferred over warfarin for breastfeeding mothers who require blood thinners due to its safety profile.
Recommendations
- Mothers who need anticoagulation therapy can typically use Lovenox while continuing to breastfeed without interruption.
- No special precautions or timing around feedings are necessary when taking Lovenox.
- It is essential to inform all healthcare providers about breastfeeding status when medications are prescribed to ensure the safest options are chosen.
- The most recent and highest quality study 1 supports the safety of Lovenox during breastfeeding, prioritizing the well-being and safety of both the mother and the infant.
From the Research
Safety of Lovenox during Breastfeeding
There are no direct studies provided that assess the safety of Lovenox (enoxaparin) during breastfeeding. However, general information about medication use during breastfeeding can be considered:
- Most commonly used drugs are relatively safe for breastfed babies, with the dose received via milk being generally small 2, 3.
- Few drugs have been demonstrated to be absolutely contraindicated during breastfeeding, and an understanding of the principles underlying the transfer into breast milk is important 2, 4.
- The main factors to consider when assessing medication safety during breastfeeding include pharmacokinetics, the duration of maternal therapy, the age of the infant, and the general health of the infant 4.
- Good resources about medicines and breastfeeding are available, including state-based medicines information services and online resources 2, 3.
Lovenox Safety in Pregnancy
While not directly addressing breastfeeding, studies on Lovenox safety in pregnancy may provide some relevant information:
- Lovenox (enoxaparin sodium) therapy appears to be safe and efficacious for pregnant women who are candidates for either prophylactic or therapeutic heparin 5, 6.
- However, the use of enoxaparin and other low-molecular-weight heparins for therapeutic anticoagulation is not recommended for pregnant women with prosthetic heart valves, and enoxaparin should be used with caution or discontinued before administration of epidural for pain relief during labor 5, 6.