Breast Feeding - Revision history

Frances.Sarkari@anthonynolan.org: /* Pseudonyms or Related Conditions */

2023-11-30T11:54:32Z

Pseudonyms or Related Conditions

← Older revision		Revision as of 11:54, 30 November 2023
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	==Pseudonyms or Related Conditions==		==Pseudonyms or Related Conditions==
	~~Breast feeding~~		Breastfeeding

	==References==		==References==

Frances.Sarkari@anthonynolan.org at 11:23, 30 November 2023

2023-11-30T11:23:31Z

← Older revision		Revision as of 11:23, 30 November 2023
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	==Pseudonyms or Related Conditions==		==Pseudonyms or Related Conditions==
			Breast feeding

	==References==		==References==

Frances.Sarkari@anthonynolan.org: /* Justification for Guidance */

2023-11-29T13:58:29Z

Justification for Guidance

← Older revision		Revision as of 13:58, 29 November 2023
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	In donors who breastfeed and are qualified to donate (taking the recovery period after pregnancy into consideration) the concern is that drugs used in the donation procedure may be ingested by and harmful for the infant. In line with this, several donor suitability guidance documents consider uninterruptible breastfeeding a contra-indication for PBSC and ask the donor if she is willing to interrupt breastfeeding during mobilization and for a couple of days after donation.		In donors who breastfeed and are qualified to donate (taking the recovery period after pregnancy into consideration) the concern is that drugs used in the donation procedure may be ingested by and harmful for the infant. In line with this, several donor suitability guidance documents consider uninterruptible breastfeeding a contra-indication for PBSC and ask the donor if she is willing to interrupt breastfeeding during mobilization and for a couple of days after donation.
	However, G-CSF is a normal component of breast milk. Limited research shows that filgrastim and lenograstim are poorly excreted into ~~breastmilk1-3~~ and are undetectable by 3 days after an injection.4		However, G-CSF is a normal component of breast milk. Limited research shows that filgrastim and lenograstim are poorly excreted into breastmilk and are undetectable by 3 days after an injection. Evidence also suggests that G-CSF given to neonates orally is not absorbed in significant quantities. In a single-center crossover study in which 22 infants received 1 dose of rhG-CSF (100 microg/kg) (10 times the subcutaneous dose) orally, no side-effects, safety issues or significant changes in plasma G-CSF concentration were observed. In a placebo controlled study G-CSF was safely given to 8 infants suffering from necrotizing enterocolitis. These studies suggest that G-CSF mainly has a local effect on the GI tract and not systemically.
	Evidence also suggests that G-CSF given to neonates orally is not absorbed in significant quantities. In a single-center crossover study in which 22 infants received 1 dose of rhG-CSF (100 microg/kg) (10 times the subcutaneous dose) orally, no side-effects, safety issues or significant changes in plasma G-CSF concentration were observed. In a placebo controlled study G-CSF was safely given to 8 infants suffering from necrotizing enterocolitis. These studies suggest that G-CSF mainly has a local effect on the GI tract and not systemically.

Frances.Sarkari@anthonynolan.org: /* References */

2023-11-29T13:56:11Z

References

← Older revision		Revision as of 13:56, 29 November 2023
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	2.Shibata H, Yamane T, Aoyama Y, et al. Excretion of granulocyte colony-stimulating factor into human breast milk. Acta Haematol. 2003;110:200–1. [PubMed]		2.Shibata H, Yamane T, Aoyama Y, et al. Excretion of granulocyte colony-stimulating factor into human breast milk. Acta Haematol. 2003;110:200–1. [PubMed]

	3.Nelson RC. Granulocyte colony-stimulating factor (G-CSF) in breastmilk of a nursing donor during hematopoietic progenitor cells (HPC) mobilization. Transfusion 2018;58 (Suppl S2):169A. Abstract. doi:10.1111/trf.14903. [CrossRef]		3.Nelson RC. Granulocyte colony-stimulating factor (G-CSF) in breastmilk of a nursing donor during hematopoietic progenitor cells (HPC) mobilization. Transfusion 2018;58 (Suppl S2):169A. Abstract. doi:10.1111/trf.14903. [CrossRef]

	4.Kaida K, Ikegame K, Fujioka T, et al. Kinetics of granulocyte colony-stimulating factor in the human milk of a nursing donor receiving treatment for mobilization of the peripheral blood stem cells. Acta Haematol. 2007;118:176–7. [PubMed]		4.Kaida K, Ikegame K, Fujioka T, et al. Kinetics of granulocyte colony-stimulating factor in the human milk of a nursing donor receiving treatment for mobilization of the peripheral blood stem cells. Acta Haematol. 2007;118:176–7. [PubMed]

	5.Calhoun DA, Maheshwari A, Christensen RD. Recombinant granulocyte colony-stimulating factor administered enterally to neonates is not absorbed. Pediatrics. 2003;112:421–3. [PubMed]		5.Calhoun DA, Maheshwari A, Christensen RD. Recombinant granulocyte colony-stimulating factor administered enterally to neonates is not absorbed. Pediatrics. 2003;112:421–3. [PubMed]

	6.Canpolat FE, Yurdakok M, Korkmaz A, et al. Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis: a placebo-controlled pilot study. J Pediatr Surg. 2006;41:1134–8. [PubMed]		6.Canpolat FE, Yurdakok M, Korkmaz A, et al. Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis: a placebo-controlled pilot study. J Pediatr Surg. 2006;41:1134–8. [PubMed]

	7.Drugs and Lactation Database (LactMed). https://www.ncbi.nlm.nih.gov/books/NBK501373/		7.Drugs and Lactation Database (LactMed). https://www.ncbi.nlm.nih.gov/books/NBK501373/

	8. Specialist Pharmacy Service. https://www.sps.nhs.uk/medicines/filgrastim/#:~:text=filgrastim		8. Specialist Pharmacy Service. https://www.sps.nhs.uk/medicines/filgrastim/#:~:text=filgrastim

Frances.Sarkari@anthonynolan.org: /* References */

2023-11-29T13:55:48Z

References

← Older revision		Revision as of 13:55, 29 November 2023
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	1.Pessach I, Shimoni A, Nagler A. Granulocyte-colony stimulating factor for hematopoietic stem cell donation from healthy female donors during pregnancy and lactation: what do we know? Hum Reprod Update. 2013;19:259–67. [PubMed]		1.Pessach I, Shimoni A, Nagler A. Granulocyte-colony stimulating factor for hematopoietic stem cell donation from healthy female donors during pregnancy and lactation: what do we know? Hum Reprod Update. 2013;19:259–67. [PubMed]

	2.Shibata H, Yamane T, Aoyama Y, et al. Excretion of granulocyte colony-stimulating factor into human breast milk. Acta Haematol. 2003;110:200–1. [PubMed]		2.Shibata H, Yamane T, Aoyama Y, et al. Excretion of granulocyte colony-stimulating factor into human breast milk. Acta Haematol. 2003;110:200–1. [PubMed]
	3.Nelson RC. Granulocyte colony-stimulating factor (G-CSF) in breastmilk of a nursing donor during hematopoietic progenitor cells (HPC) mobilization. Transfusion 2018;58 (Suppl S2):169A. Abstract. doi:10.1111/trf.14903. [CrossRef]		3.Nelson RC. Granulocyte colony-stimulating factor (G-CSF) in breastmilk of a nursing donor during hematopoietic progenitor cells (HPC) mobilization. Transfusion 2018;58 (Suppl S2):169A. Abstract. doi:10.1111/trf.14903. [CrossRef]

Frances.Sarkari@anthonynolan.org: /* References */

2023-11-29T13:55:22Z

References

← Older revision		Revision as of 13:55, 29 November 2023
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	==References==		==References==

			1.Pessach I, Shimoni A, Nagler A. Granulocyte-colony stimulating factor for hematopoietic stem cell donation from healthy female donors during pregnancy and lactation: what do we know? Hum Reprod Update. 2013;19:259–67. [PubMed]
			2.Shibata H, Yamane T, Aoyama Y, et al. Excretion of granulocyte colony-stimulating factor into human breast milk. Acta Haematol. 2003;110:200–1. [PubMed]
			3.Nelson RC. Granulocyte colony-stimulating factor (G-CSF) in breastmilk of a nursing donor during hematopoietic progenitor cells (HPC) mobilization. Transfusion 2018;58 (Suppl S2):169A. Abstract. doi:10.1111/trf.14903. [CrossRef]
			4.Kaida K, Ikegame K, Fujioka T, et al. Kinetics of granulocyte colony-stimulating factor in the human milk of a nursing donor receiving treatment for mobilization of the peripheral blood stem cells. Acta Haematol. 2007;118:176–7. [PubMed]
			5.Calhoun DA, Maheshwari A, Christensen RD. Recombinant granulocyte colony-stimulating factor administered enterally to neonates is not absorbed. Pediatrics. 2003;112:421–3. [PubMed]
			6.Canpolat FE, Yurdakok M, Korkmaz A, et al. Enteral granulocyte colony-stimulating factor for the treatment of mild (stage I) necrotizing enterocolitis: a placebo-controlled pilot study. J Pediatr Surg. 2006;41:1134–8. [PubMed]
			7.Drugs and Lactation Database (LactMed). https://www.ncbi.nlm.nih.gov/books/NBK501373/
			8. Specialist Pharmacy Service. https://www.sps.nhs.uk/medicines/filgrastim/#:~:text=filgrastim

	==Version==		==Version==

Frances.Sarkari@anthonynolan.org: /* Justification for Guidance */

2023-11-29T13:54:12Z

Justification for Guidance

← Older revision		Revision as of 13:54, 29 November 2023
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	In donors who breastfeed and are qualified to donate (taking the recovery period after pregnancy into consideration) the concern is that drugs used in the donation procedure may be ingested by and harmful for the infant. In line with this, several donor suitability guidance documents consider uninterruptible breastfeeding a contra-indication for PBSC and ask the donor if she is willing to interrupt breastfeeding during mobilization and for a couple of days after donation.		In donors who breastfeed and are qualified to donate (taking the recovery period after pregnancy into consideration) the concern is that drugs used in the donation procedure may be ingested by and harmful for the infant. In line with this, several donor suitability guidance documents consider uninterruptible breastfeeding a contra-indication for PBSC and ask the donor if she is willing to interrupt breastfeeding during mobilization and for a couple of days after donation.
	However, G-CSF is a normal component of breast milk. Limited research shows that filgrastim and lenograstim are poorly excreted into breastmilk1-3 and are undetectable by 3 days after an injection.4		However, G-CSF is a normal component of breast milk. Limited research shows that filgrastim and lenograstim are poorly excreted into breastmilk1-3 and are undetectable by 3 days after an injection.4
	Evidence also suggests that G-CSF given to neonates orally is not absorbed in significant quantities.5 In a single-center crossover study in which 22 infants received 1 dose of rhG-CSF (100 microg/kg) (10 times the subcutaneous dose) orally, no side-effects, safety issues or significant changes in plasma G-CSF concentration were observed.5 In a placebo controlled study G-CSF was safely given to 8 infants suffering from necrotizing enterocolitis.6 These studies suggest that G-CSF mainly has a local effect on the GI tract and not systemically.		Evidence also suggests that G-CSF given to neonates orally is not absorbed in significant quantities. In a single-center crossover study in which 22 infants received 1 dose of rhG-CSF (100 microg/kg) (10 times the subcutaneous dose) orally, no side-effects, safety issues or significant changes in plasma G-CSF concentration were observed. In a placebo controlled study G-CSF was safely given to 8 infants suffering from necrotizing enterocolitis. These studies suggest that G-CSF mainly has a local effect on the GI tract and not systemically.

Frances.Sarkari@anthonynolan.org at 13:51, 29 November 2023

2023-11-29T13:51:21Z

← Older revision		Revision as of 13:51, 29 November 2023
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	==Pseudonyms or Related Conditions==		==Pseudonyms or Related Conditions==

			==References==

	==Version==		==Version==
	Version 1, Edition 1		Version 2, Edition 1

	====Date of Last Update====		====Date of Last Update====
	~~24th October 2012~~		29/11/2023

Frances.Sarkari@anthonynolan.org: /* Justification for Guidance */

2023-11-29T13:49:35Z

Justification for Guidance

← Older revision		Revision as of 13:49, 29 November 2023
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	'''PBSC harvest'''		'''PBSC harvest'''

	G-CSF is ~~known~~ to be ~~secreted~~ in breast milk (~~Kaida et al~~, ~~Act Haematol 2007): it is unknown whether oral~~ G-CSF ~~would have any clinical~~ effect on the ~~infant~~.		Breast-feeding donors may donate by PBSC if they are prepared to stop breast-feeding on commencing G-CSF injections and to abstain for three days following their donation. It is safe for the mother to express before this three-day period has expired, but the expressed milk should be discarded.

			In donors who breastfeed and are qualified to donate (taking the recovery period after pregnancy into consideration) the concern is that drugs used in the donation procedure may be ingested by and harmful for the infant. In line with this, several donor suitability guidance documents consider uninterruptible breastfeeding a contra-indication for PBSC and ask the donor if she is willing to interrupt breastfeeding during mobilization and for a couple of days after donation.
			However, G-CSF is a normal component of breast milk. Limited research shows that filgrastim and lenograstim are poorly excreted into breastmilk1-3 and are undetectable by 3 days after an injection.4
			Evidence also suggests that G-CSF given to neonates orally is not absorbed in significant quantities.5 In a single-center crossover study in which 22 infants received 1 dose of rhG-CSF (100 microg/kg) (10 times the subcutaneous dose) orally, no side-effects, safety issues or significant changes in plasma G-CSF concentration were observed.5 In a placebo controlled study G-CSF was safely given to 8 infants suffering from necrotizing enterocolitis.6 These studies suggest that G-CSF mainly has a local effect on the GI tract and not systemically.

	Breast-feeding donors may donate by PBSC if they are prepared to stop breast-feeding on commencing G-CSF injections and to abstain for one week following the last dose of G-CSF. It is safe for the mother to express before this one-week period has expired, but the expressed milk should be discarded.

Frances.Sarkari@anthonynolan.org: /* Guidance */

2023-11-29T13:46:54Z

Guidance

← Older revision		Revision as of 13:46, 29 November 2023
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	==Guidance==		==Justification for Guidance==

	We generally recommend that breast-feeding mothers do not donate and, regardless of breast-feeding, donation is not permitted within six months of a term pregnancy.		We generally recommend that breast-feeding mothers do not donate and, regardless of breast-feeding, donation is not permitted within six months of a term pregnancy.