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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