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Individuals who have received kidney transplants face a higher likelihood of delivering preterm infants and giving birth to babies with a low birth weight when compared with the general population. In this context, breastfeeding is increasingly important because of its advantages for preterm infants. Despite the well-established benefits of breastfeeding for both the mother and infant, the traditional recommendation has been to avoid nursing due to potential drug transmission through breast milk. However, emerging evidence suggests that certain immunosuppressants may be compatible with breastfeeding, challenging long-standing clinical guidelines. In this review, we examine the current literature on the pharmacokinetics, safety profiles, and clinical outcomes associated with key immunosuppressive agents, including cyclosporine, tacrolimus, everolimus, azathioprine, corticosteroids, and belatacept. Our work highlights that all published reports to date on the studied treatments indicate that the amount of the drug reaching breast milk is considered safe for the child\u2019s health. These conclusions, however, are derived from very short-term measurements and small numbers of patients. Therefore, we emphasize the need to design structured prospective studies to assess safety in the medium and long term. Our review aims to equip clinicians with the most up-to-date evidence on this topic, enabling them to make informed decisions regarding the compatibility of post-kidney transplant treatments with breastfeeding.<\/jats:p>","DOI":"10.3390\/jcm14072364","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T02:50:16Z","timestamp":1743389416000},"page":"2364","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Compatibility of Post-Kidney Transplant Immunosuppression Therapy with Lactation"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4587-3648","authenticated-orcid":false,"given":"Gema","family":"Gomez-Casado","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2014IBIMA Plataforma BIONAND, University of Malaga, 29010 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juana","family":"Alonso-Titos","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2014IBIMA Plataforma BIONAND, University of Malaga, 29010 Malaga, Spain"},{"name":"Nephrology Department, Regional University Hospital of Malaga, RICORS2040 (RD21\/0005\/0012-RD24\/004\/0026), 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7106-092X","authenticated-orcid":false,"given":"Ernesto","family":"Gonzalez-Mesa","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2014IBIMA Plataforma BIONAND, University of Malaga, 29010 Malaga, Spain"},{"name":"Department of Surgical Specialties, Biochemistry and Immunology, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain"},{"name":"Department of Obstetrics and Gynecology Service, Regional University Hospital of Malaga, 29010 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Ortega-Gomez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga\u2014IBIMA Plataforma BIONAND, University of Malaga, 29010 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 M\u00e1laga, Spain"},{"name":"CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"key":"ref_1","first-page":"57","article-title":"CT06 Chapter 4: Report from the National Transplantation Pregnancy Registry: Outcomes of Pregnancy After Transplantation","volume":"4","author":"Armenti","year":"2006","journal-title":"Clin. 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