Hi Ellen,

The mom has topical antibiotic at the ready...her own breastmilk...

Since "acne" is really a description of the skin rather than a diagnosis of the process that 
is causing the condition the mom might find it helpful to do research on the web...

There are many many types of acne, and many kinds that do not dramatically improve 
even on antibiotics...so even if she weaned to take the antibiotic regimen the doctor is 
recommending there is no guarantee she would get better due to the antibiotic

One thing that comes to mind is that since she experienced "steriod acne" while pregnant 
especially at delivery the improvement of her first case of acne could have been 
coincidental to weaning not the cause of the improvement...

On the other hand if the improvement was not coincidental it could be that her acne while 
caused in the first place by the hormones of pregnancy at this point is being affected by 
the low female hormones and alterations in hair growth cycle caused by birth and 
lactation....

Antibiotics don't do much if anything to help acne that is caused by abnormalities of the 
keratinization of the follicle although they could help with secondary infections...

When a problem like this presents with a breastfeeding mother I encourage her to have 
the conversation with her doctor "what if"...

"What if I weren't breastfeeding and my acne wasn't improving on antibiotics 
what would you do for me then?"

There are a lot of other topical preparations that he would offer her and even 
phototherapies...

No matter what the problem if a mother is breastfeeding that seems to become the 
doctor's focus rather than the condition she is presenting to him, but with persistence 
most mothers can get their physicians to re-focus back on the condition...

After she knows her full range of options she can use Hale and other sources to educate 
the doctor about which of the options are compatible with breastfeeding...

Did the mother have any blood incompatibilities with the baby?

Jen O'Quinn IBCLC

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