Date: February 19, l996
From: Kathy Bell, RN, IBCLC
Subject: Introduction and Questions

I am a new subscriber to Lactnet and have been very interested in
the lively exchanges I've read so far.
I am a lactation consultant and staff nurse on a very supportive
LDRP unit in south-central PA(extremely low epidural rate; close
to 70% initiation of BF). I have been a childbirth educator for
twelve years.  Currently I am working on my MS in nursing in the
women's health NP program at University of Maryland at Baltimore.
I have three daughters who were breastfed two plus years each and
a very understanding husband who is helping me become more
computer literate.
I am looking for quick information with references on the use of
NSAIDS, particularly Ibuprofin and Ketorolac in postpartum
breastfeeding mothers of term infants.  We use Ibuprofin
routinely, but I am having a difficult time convincing our
hospital pharmacy that there is supportive evidence on the safe
use of Ketorolac for a limited time in mothers of term infants.
This drug is present on the American Academy of Pediatrics list
as generally safe, and I have a copy of the article from the
European Journal of Clinical Pharmacology.  Anything else
available?  The hospital pharmacy wants to reference only the
product insert from the drug company which contraindicates the
use of Ketorolac in BF moms.
Next question is on the use of Diflucan in moms with yeast
infections of the nipple or breast - can they use this and
continue to nurse?  Is anyone using it for infants?  Alas, my
copy of Dr. Hale's book has not yet arrived! I am seeing lot's of
yeast infections recently, some of which are very stubborn and
not responding to standard measures.
Thanks!  Kathy