Hello!  I'm currently supporting and providing information to a mother who
is nursing a 15 month old toddler.   I have her permission to post here as I
have given her what I can with my resources (mainly Hale).

The mom was diagnosed with Lyme Disease and a Bartonella co-infection and
was prescribed Rifampin (for the Bartonella) and Cefdinir (prescribed for
the Lyme disease), but had an allergic reaction two weeks ago which landed
her in the ER (with hives, swollen lips, chest pain).  Her doctor presumed
that it was the Cefdinir (since that been taken for less time).

Sadly, her breastfeeding toddler has also just been diagnosed with active
and old Lyme infections, but has not yet begun treatment.

This mom is willing to try Amoxicillin (an L1 drug and one that the toddler
might also be prescribed), but she is likely to have an allergic reaction to
it (because of the likely Cefdinir reaction, it's presumed likely
allergenic) and won't be able to complete full treatment with it.  If this
allergic reaction occurs, the only choice seems to be long term Doxycycline
(L3 for short term and L4 for chronic use; her doctor is recommending five
months), but, of course, the toddler could likely benefit especially from
the extra immune protection since the toddler also has Lyme.

Wondering if there's anyone who has more experience with long term
Doxycycline use especially with toddlers (who nurse less often, etc.) to
help this mom weigh the pros and cons.

Lyme is totally endemic where we live, and I expect to get more calls about
it in the future.

Thanks!!
Alexis Jette Borggaard
Nursing Mothers' Counselor, Lexington, MA Chapter

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