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Subject:
From:
Rachael Spencer <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 4 Dec 2008 04:35:48 -0800
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Dear Rachael,
 
I am off-line from Lactnet for a bit...but was hoping you might post a question for me, actually two.
 
I have a pregnancy client who is equivocal for Rubella and am trying to find her a Rubella vaccine, without the combination MMR.  I think I have found it through Merck, but also found this warning regarding nursing mothers.  
 
Nursing Mothers
Recent studies have shown that lactating postpartum women immunized with live attenuated rubella

vaccine may secrete the virus in breast milk and transmit it to breast-fed infants.33 In the infants with

serological evidence of rubella infection, none exhibited severe disease; however, one exhibited mild 
clinical illness typical of acquired rubella.34,35 Caution should be exercised when MERUVAX II is 
administered to a nursing woman.
 
It is my understanding that both the individual Rubella (Meruvax II) and the MMR are live viruses.  Am I unaware of a safer option for breastfeeding mothers, or is this the standard vaccine for immediate postpartum use, breastfeeding or not?
 
My second question is regarding Lotrimin AF.  I have a client (unfortunately, I don't have prescription privileges) that has yeast in one of her breasts and her FP will only order Lotrimin for her.  I have sent a plethora of information and he is as appalled with me, as I am with him.  I have been off Lactnet for quite sometime, but am I way off base encouraging her to seek another prescribing practitioner?
 
Blessings to you, Penny
Please respond privately to [log in to unmask] 

 Penny Lane BA, MSN, CNM
Believe Midwifery Services
www.believemidwiferyservices.com 



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