This from a subscriber...posted anonymously to protect identity. THank you.
There has been a recent death of a baby who was breastfed, and I would like
your opinions on the medications mom was taking. I only became aware of
the situation after the death.
This is not to lay blame of any kind. It is as a springboard for
discussion and self-awareness. Studies and tests on the baby's tissues
are still being done. As the death occured prior to 28 days, it may not be
considered a SIDS.
The situation: a baby born at about 5 lbs. Mother developed postpartum
cardiomyopathy and congestive heart failure and was hospitalized. During
the hospitalization, baby was partially breast fed, then mom pump and
dumped as they tried to identify the medications that would stabilize her
condition and be compatible with breastfeeding. After discharge mom
resumed exclusive breastfeeding and baby died during the night in her
parents' bed.
Mom was discharged taking the following medications. I looked up what I
could and this is what I found:
hydralazine - 25 mg tid - AAP says OK, Hale calls it an "L2"
isosorbide dinitrite - 10 mg tid - too new - no studies that I can find, in
books or on-line. It's for angina, can cause low blood pressure leading to
dizziness and fainting.
furosemide - 20 mg OD - nothing in AAP, Hale calls it an "L3", but it is
used in neonates
metoprolol - 50 mg bid - OK by AAP, Hale calls it an "L3" and recommends
using propanolol instead
K-tab - 10 mg OD - couldn't find anything on this either, it's potassium
replacement often given with diuretics.
My biggest concern is that side effects for babies of Hydralazine, Isordil,
Metoprolol is all "weakness and low BP"
Metoprolol and Hydralazine say: "Observe for sedation"
Could each medication individually be considered "safe", but the
combination be too much, especially with a small baby and prior to the
"maturation" or "swelling" of the alveolar cells?
Of course hind-sight is 20-20. I would like feedback to become better
informed and aware.
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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