Brenda,
This is a very difficult situation. The neonatologist really is trying to
look out for the baby. Most docs are so comfortable w/ formula they will
choose it over ebm in these cases. I guess no one really knows what, if
anything, the diclox in ebm would do to the baby. I think most of us
lactnetters would agree that the baby will be at far greater risk of
diarrhea and other illnesses w/ a 12 day cessation of breastfeeding.
I would copy the info  from Hale and share w/ the neo. I would emphasize
that the med is 96% protein bound, molecular wt of 420 (I'm using my older
Hale ref from home, but assume this info is the same in his latest edition),
and the L1 rating . He may decide to 'allow' the bf. You could also offer a
compromise, using the info that the drug peaks at 0.5 to 2 hrs. That is to
say, the mother could express and then take her dose, and wait maybe 4 hrs
to pump again, figuring out a way to express prior to her dosing. Hopefully
mom has a good supply and could still supply the baby the ebm and discard or
freeze the 'peak milk' for later use.
Sometimes when I am trying to educate, I find it is very helpful to share
the info in the preface and 'how to use this book' info of Hale's book on
the pharmacokinetics i.e. protein binding, peaks, etc.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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