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From:
Melissa Senf <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 15 Oct 2011 07:31:53 -0400
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I just wanted to throw this out there for you to think about.  I have worked in an ED where we have seen patients on these sort of medications.  My heart goes out to them because the addictions can be very powerful.  I'd be very concerned about getting the mother healthy and coping well with weaning off the meds before anything.  This can get to be a very, very complicated issue.  Best of luck!
 
Also very thankful for doctors who are collegial!
Melissa Senf, RN, IBCLC

>>> Dawn Kersula <[log in to unmask]> 10/14/2011 2:07 PM >>>
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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