Anthrax Immune Globulin Intravenous (Human) and Breastfeeding

Summary of use during lactation

No information is available on the clinical use of anthrax immune globulin during breastfeeding. Anthrax immune globulin is an immune globulin (IgG) rich in IgG antibodies against Bacillus anthracis toxins. IgG is a normal component of breastmilk that is likely to be partially destroyed in the infant's gastrointestinal tract and poorly absorbed by the infant during breastfeeding. Anthrax immune globulin can be given intravenously to infants weighing less than 5 kg. No special precautions are required during breastfeeding.[1] Women with active skin lesions from anthrax on the breast should avoid infant contact with the affected breast and not breastfeed from that breast until 48 hours after appropriate antimicrobial therapy has been initiated. Expressed breastmilk can be used safely if hygiene and protective precautions were taken during expression, including handwashing and ensuring that no lesions come in contact with pump equipment if using a pump.[1]

Drug levels in milk and infant serum

Maternal Levels. Colostrum (3 days postpartum) and milk (7 days postpartum) samples from 2 mothers who were receiving intravenous immunoglobulin (IVIG) for the treatment of common variable immunodeficiency were studied. One mother was receiving 400 to 500 mg/kg of IVIG monthly and the other received 600 to 700 mg/kg of IVIG monthly. The time of the last dose before sample collection was not reported. Immune globulin G (IgG) concentrations were normal in the first mother's colostrum and milk and higher than normal in the colostrum of the second mother. IgM levels were normal in the colostrum and milk first mother and low in the second.[2] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

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

Effects on lactation and breastmilk

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

References

1. Leslie S, Ververs M. Chemical and biological threats: Guidance for breastfeeding women, infants, and young children. Health Secur 2024;22:172-81.38416870 PubMed
2. Palmeira P, Costa-Carvalho BT, Arslanian C, et al. Transfer of antibodies across the placenta and in breast milk from mothers on intravenous immunoglobulin. Pediatr Allergy Immunol 2009;20:528-35.19220771 PubMed