Q #1: Can anyone clarify this from Hale pg.245:
"L4 if used early postpartum", L2 after that
In reading other entries, I don't think I can *assume* this is the equivalent of neonatal period, or first 30 days.

Q #2: Is is necessary to pump & dump while taking Mavik?

We had a mom with chronic hypertension who delivered a girl at 35w5d gestation on 07/18/03 at 1653, weight 2466gm. She is in Level II. Mom was given Aldamet bit it had no effect on mom's condition. MD ordered Enalapril (pg. 245 in Hale 2002) but the pharmacy was out & sent Mavik (trandolapril) instead. That is not in Hale or Briggs. Found it in Nurses' Drug Guide 2001 which indicated it peaked in 1-10 hours, normal dose 1mg, 2mg or 4mg, QD (4 times a day); no specific info on BFing. Mom was told to pump & dump while on Mavik. She has had 2 doses of 2mg each, but will start Enalapril at home when she can get it from an outside pharmacy. Enalapril is AAP Approved but carries that L4/L2 caveat.

This is probably for future reference now as both mom & baby are d/c'd today together, unless someone responds before she leaves the building. She knows she can breastfeed while taking Enalapril & her MD has been given a copy of the appropriate page in Hale's book.

Thanks.

Phyllis Adamson, IBCLC, RLC
Glendale, AZ
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