Mary Kay,
Although it sounds like this mom has multiple issues, the Zyrtec is very
probably a significant contributer to her supply problem. As I'm sure
you know, Zyrtec is a prescription strength antihistamine, and one of
the most potent that we use. Benedryl has been shown to greatly
decrease milk supply, and Zyrtec will certainly have the same effect on
supply.....although possibly to a greater extent and for a much longer
period. Since Zyrtec is long acting (taken only once a day)...and this
mom has been using it for two years, it may take several days to
completely clear the metabolites.
Also, If this mom has been taking Zyrtec to help her sleep, was she
sleeping through night feedings in those first nine days? Is the small
amount of Zyrtec that is being passed to the baby possibly making the
jaundice baby even more sleepy???
One other thought...you describe this mom as "anxious and hyper", and
she admittedly has been taking the Zyrtec to "help her sleep"......do
you think there might be a depression issue here? You might also
consider screening for a thyroid issue.
If mom's allergies are severe and she needs medication beyond the nasal
spray, you may ask her doc about the possibility of replacing the Zyrtec
with Singulair. Singulair should not have the same drying effects as
the antihistamine, has very few side effects, is not sedating and is now
indicated for allergies. We are having very good results in our
practice using Singulair for allergic rhinitis. I would further
investigate possible underlying reasons for mom's sleep problems?
I wish I had this many ideas during "normal" hours!!!!! lol
Susan, PNP
PS: Thirst is also another side effect of the Zyrtec, or any antihistamine.
Mary Kay Smith, RN, IBCLC wrote:
>I met with a client last night who has a low milk supply and a nine day old
>who has not stooled since Wednesday. He is nine ounces below birth weight and
>was being supplemented until Wednesday (due to "high bilirubin) when the
>pediatrician said it was OK to quit the supp. She had not been pumping during that
>time and he was getting 8 oz. per day! When we pumped she got 20 ccs after
>twenty minutes of pumping with a Classic(single kit, her choice, switching every 5
>minutes). She also c/o being thirsty all the time. He is not transferring
>much at the breast either so I recommended that we get back to supplementing
>while working on increasing the milk supply. Mom is also very anxious and hyper.
>She is taking Zyrtec and using Flonase for "allergies and has been for the last
>two years. She said the Zyrtec "helps her sleep."
>Has anyone else had this experience with Zyrtec?
>Mary Kay Smith, RN, IBCLC
>Canton MI USA
>
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