Hi Dawn and others,
Do you mean that you would ask the client's physician first, and then call
on the other resources?  Or would you gather the info first and then take it
to the physician?  I am just asking because I have called the Infant Risk
Center several times to get more information about drugs, but I have usually
done it the other way around.  After speaking to the mom, I would gather all
the information I could, and then call the doctor to share the information,
but maybe that is not the right protocol.  I feel like I am still learning
the right way to go about such things.

I guess actually the times I have encountered these questions, the mom
hasn't always been told not to breastfeed already, or she is still pregnant,
etc.  So would you handle it differently if you were approaching a physician
who had already told the mom not to breastfeed vs someone who was still just
gathering information?

Thanks!
Sonya Shaver, BS, CHES, IBCLC

On Fri, Oct 14, 2011 at 2:07 PM, Dawn Kersula <[log in to unmask]>wrote:

> Jennifer and colleagues,
>
> I just had a situation that reminds me of this. It was a mom on pretty high
> doses of two different medications. The doctor wasn't even aware that this
> mom was hoping to give this second baby colostrum; the nurses had looked up
> the meds in Hale and said, "Oh, this will be fine."
>
> But I think we always need to take a deep breath and think things through,
> and talk with the infan't doctor beforehand. I was not comfortable saying,
> "Oh sure, no problem" - because I am very at ease most of the time, but I
> don't know enough about these drugs to know about interactions, and I don't
> know what difference it can make if a mom was on all these meds during
> pregnancy as well as mom then breastfeeding.
>
> So I called the doctor while the mom was in early labor. I explained the
> situation and said I wasn't comfortable because I didn't know enough - and
> she laughed and said if I didn't know, she sure didn't know either. We
> agreed that I would call someone who would know more than we did, and get
> back to her.
>
> She's a Boston-educated MD and had a number for Brigham and Women's that
> she
> wanted me to try first. There was no answer so I suspect they no longer
> have
> a hotline (but it was MD-to-MD info, and that would have reassured her.) I
> could have called U Rochester next - but since I know and trust Tom Hale, I
> called the Infant Risk Center instead.
>
> They needed to confer with Dr. Hale, and had to get back to me. The answer
> was what I wanted to hear (she could safely nurse the baby) -- and I
> contacted the doctor with the info.
>
> The mom you describe is on a lot of meds. Why not use these good
> resources?Let the doc know that the mom contacted you, that you looked up
> each med individually, but can get a consult FOR FREE! no less! - and see
> what they say. It will be a good learning situation for everyone.
>
> Dawn Kersula MA, RN, IBCLC in Vermont - thankful for doctors who are
> collegial!
>
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