Pancrelipase and Breastfeeding

Summary of use during lactation

Pancrelipase has been used in mothers of breastfed infants with apparent allergy to proteins in breastmilk derived from the maternal diet. This technique seems to have improved symptoms of egg allergy and cow’s milk allergy, such as blood in the stool and colic.[1-3] Pancreatic enzymes are not appreciably absorbed from the mother’s gastrointestinal tract, so they should not reach the infant. Expert opinion considers use of pancrelipase to be acceptable during breastfeeding.[4,5]

Drug levels in milk and infant serum

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.

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. Des Roches A, Abbott M, Begin P, et al. Oral pancreatic enzyme supplements can reduce excretion of ovalbumin in breast milk. J Investig Allergol Clin Immunol 2014;24:62-3.24765885 PubMed
2. Repucci A. Resolution of stool blood in breast-fed infants with maternal ingestion of pancreatic enzymes J Pediatr Gastroenterol Nutr 1999;29:500.
3. Schach B, Haight M. Colic and food allergy in the breastfed infant: Is it possible for an exclusively breastfed infant to suffer from food allergy? J Hum Lact 2002;18:50-2.11845737 PubMed
4. Middleton PG, Gade EJ, Aguilera C, et al. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J 2020;55:1901208.31699837 PubMed
5. ABM Clinical Protocol #24: Allergic proctocolitis in the exclusively breastfed infant. Breastfeed Med 2011;6:435-40.22050274 PubMed