Patricia
You are right that it really is a case by case basis. Preterm and sick
babies are not in the same category as healthy term well babies. And,
besides this, you will not make any friends in the nicu or with the docs if
you don't take this into account. I'm sure most of us on lactnet would feel
that the benefits of bf outweigh most of the risks of meds in breastmilk.
However it is best to look at the pharmacokinetics of the drugs in question
and also the gestational age, particular illness, etc of the neonate. You
could have a discussion with the attending and ask how could some, if not
all, breastfeeding or breastmilk feeding be done, around this med? Like,
avoid the peak of the med, bf right before the dose, etc. If you have access
to Tom Hale's med books they explain all of that and staff can come up with
a very workable plan. Hope this helps.
Laurie Wheeler RN MN IBCLC
New Orleans Louisiana USA

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