Re: << I have a very young mom-to-be (18 years old) with a heart condition.
She is on "Sotalol (Endaral, sp?)" (her typing, not mine so I didn't
make a typo - I think she said it was a beta-blocker), and she
believes that this medication would kill her child in 3-5 minutes
after nursing if she were to nurse while on this. She really wants
to breastfeed, but her cardiac specialist has her scared to death
(literally - he's the one that told her her baby's heart would slow
to a stop within 3-5 minutes of breastfeeding). To me, this just
seem 'too radical' of an effect from medications. >>


Hale (2004, 11th ed.) has info on Inderol and Sotalol, which are two different beta-blocker meds. Relative dose to infant re: Sotalol is 25.4%, but the AAP lists it as a maternal med "usually compatible with BF" and in one study Hale notes there was "no evidence of toxicity in 12 infants." Under Pedi Concerns, he lists: "none reported via milk, but observe for sedation, bradycardia, hypotension, weakness." Propranolol (Inderal) and Metoprolol are cited as alternatives. Hale lists Sotalol as Risk L3 (moderately safe).

OTOH, per Hale the relative dose to infant re: Inderal (Propranolol) is 0.1%; it also is AAP considered "usually compatible with BF," and Hale lists it as L2 (safer) with re: Pedi Concerns " none reported via breastmilk in numerous studies."

An important issue with this young expectant mom is that she appears to think or has given the impressin that two different meds are the same one. At 18 y.o. with a cardiac condition it will be important for her to gain a sense of empowerment regarding her ongoing treatment -- now and throughout her lifespan. She can learn what her meds are, how they're correctly spelled and how each works. She can learn how to investigate alternative treatments to discuss with her M.D.s (which based on what you've written stands for someone who thinks it means Major Deity). Incubating and then nurturing a baby can provide a powerful incentive to take control of her own care! Tell her we're all rooting for her...

Karen Gromada




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