Hi-

I have a situation where a mom, two weeks post partum is thinking about
giving up breastfeeding due to her cardioligists advice.  She has agreed to
let me describe her condition.

First of all, babe is thriving and a great breastfeeder, no problems except
for jaundice in the beginning and that was helped along with a wallaby.

Prior to pregnancy, mom was diagnosed with a heart condition that she said
the cardiologist explained to her as this. "She has an inappropriate
response to adrenaline" "her body has a hypersensitivity to adrenaline in
which she becomes tachycardic" Secondary to this condition she has
a "loose" heart valve that when she becomes tachycardic, it does not seal
properly and thus blood flow to and from the heart is not ideal" She was
place on Zebata 5mg twice/day with the option of taking 10mg for the second
dose if she was working out (she did a lot of cardiovascular exercise) If
she is doing minimum exercise like walking, she was able to get by with
just the 5mg at the second dose. During her pregnancy, she was off the meds
(and she felt awful that first trimester with walking!) for the first
trimester, then was able to go back on the meds for a while until about 32-
34 weeks where she was then told to work from home so she would not have
extra stressors to elevate heart rate(lucky her job allowed this!)

Now after delivery, she was told she could not take zebata with
breastfeeding and was given attenolol which worked for a short period of
time (about 4 hrs) then it was not very effective. Going for walks with
babe outside lead her to be very short of breath and worn out. She would
love to continue breastfeeding, but is getting to the point where she is
tired of feeling so worn out and worried that she might not be able to care
for her little one effectively.

My question is: Is there any new evidence that Zebata is safe to take while
breastfeeding? (our current copy of Dr. Hale's book is a few years old, we
are trying to get a new one soon, but haven't yet done so...)

I'm sorry if I don't have the technical information correct, I'm getting
this second-hand. Cardiologist would probably be very willing to work with
mom if medication is considered safe. (She had 4 little ones that she
breastfed!)

Thank you for your responses to this question!

Kristi Perrin, RN,BS
Maternal Child Health Program
HOMEWARD
Mary Greeley Medical Center
Ames, IA
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