Is Enoxaparin safe while breastfeeding?

Effects on the breastfed infant

Ten women received enoxaparin 20 mg and 2 received 40 mg daily by subcutaneous injection from the prepartum to the postpartum period. At 5 to 7 days postpartum, anti-Xa activity (a measurement of enoxaparin anticoagulant activity) was undetectable in their 12 completely breastfed term neonates 1.5 to 3 hours after they were breastfed for at least 5 days. No bleeding was detected among the infants during maternal enoxaparin therapy.[ 2 ] A pregnant woman suffered blood clots in the sinuses and 2 small intracranial hemorrhages at 8 weeks of gestation, followed by status epilepticus. She was treated with enoxaparin 40 mg twice daily throughout pregnancy and for 3 months postpartum as well as levetiracetam and lacosamide. Her infant was about 50% breastfed for the first 15 days of life. The infant showed normal development at 7 months of age.[ 3 ] Following a successful uterus transplant and embryo transfer, a newborn infant was breastfed by a mother taking tacrolimus, azathioprine 150 mg (2 mg/kg), prednisone 5 mg, and enoxaparin 40 mg daily. The tacrolimus dosage was adjusted to achieve a serum concentration of 5 to 7 mcg/L. The mother breastfed (exclusively?) for 8 weeks and weaned over the next 4 weeks. At 15 months, the infant was achieving all developmental milestones.[ 4 ]

Effects on milk supply

Relevant published information was not found as of the revision date.

Levels in milk

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Alternatives LactMed lists

• Acenocoumarol
• Dalteparin
• Enoxaparin
• Heparin
• Rivaroxaban
• Warfarin