Can a breastfeeding woman take Infliximab at age 33?

Question

Hello doctor,

I am 33, and my Crohn’s disease has been acting up really badly since I had my baby eight months ago. The disease was in remission during pregnancy, but now I am having severe abdominal pain and diarrhea six to seven times daily with blood and mucus.

My periods came back two months ago, but they are really heavy and painful, utterly different from before pregnancy. I am still breastfeeding, but the Crohn’s medications are making me worried about the milk supply and safety for the baby.

The GI doctor wants to start Infliximab infusions, but I am not sure if it is safe while nursing. My iron levels are really low (ferritin 12 ng/mL) from all the bleeding, and I am exhausted all the time. The inflammation around my rectum is so bad that it hurts to sit down, and changing diapers is becoming really difficult.

Could the hormonal changes from breastfeeding be making my Crohn’s worse?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I am genuinely sorry you are going through all of this while trying to care for your little one. It sounds exhausting, both physically and emotionally.

What you are describing does sound like an active Crohn’s (a type of inflammatory bowel disease (IBD) that causes your digestive tract to become swollen and irritated) flare, likely triggered by the hormonal shifts after pregnancy and the stress of new motherhood. Unfortunately, this is not uncommon.

Infliximab is actually considered safe during breastfeeding. Multiple studies have shown that only tiny amounts pass into breast milk, and they do not seem to affect the baby’s immune system. Many women with Crohn’s successfully continue nursing while on this treatment. That said, it is entirely okay if you choose to wean or adjust breastfeeding to feel more in control.

As for your heavy periods and iron levels, low ferritin (like your value of 12 ng/mL) is very likely contributing to your fatigue. Iron supplements, either oral or intravenous, can help boost your energy as you recover. Treating the flare is also key to stopping the bleeding and helping your iron stores rebound.

The rectal pain you are feeling sounds severe and may indicate perianal Crohn’s (inflammation around the anus), which often needs both medical and sometimes local supportive treatment, like sitz baths or topical pain relief.

Please know you are not alone. You are doing an incredible job under challenging circumstances. The good news is that Crohn’s flares can be brought under control, and there are safe options even while breastfeeding.

Please follow up in one to two weeks after starting Infliximab, or sooner if you experience worsening symptoms or fevers, breastfeeding concerns persist, or you are unable to tolerate oral iron.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.