To:    Yanet
Re:     Elevated Cholesterol

        I'm not sure,  but I assume from the sound of the drugs,  that you
are asking about Mevacor(lovastatin)  and Propranolol.

        Mevacor(lovastatin) inhibits the production of cholesterol by
inhibiting an enzyme in the early stages of cholesterol synthesis,  hence,
cholesterol release from the liver is reduced significantly(40%).  We know
that lovastatin is secreted into rodent milk,  but no published studies
concerning human milk are yet available.  Two points should be reviewed:

        1)  Does elevated cholesterol in mom's blood,  lead to elevated
cholesterol in milk,  and does it really matter ?   The alveolar transfer of
cholesterol into human milk appears to be tightly controlled.   Dietary
manipulation, and presumably elevated plasma cholesterol levels,  do NOT
change the cholesterol level in milk.   Breastfed infants tend to have
higher cholesterol levels anyway, when compared to bottle fed infants.
Since I am a strong believer in "natures way",  there is probably a very
good reason why human breast milk has higher levels of cholesterol(it
probably enhances cell wall growth),  and we humans are just too stupid to
understand why(so, don't fix it if its not broken).  Ruth Lawrence's book
has a good review of cholesterol.


        (The following is a personal opinion)...

        2)  Hypercholesterolemia is a lifelong problem.   Atherosclerotic
disease does not occur overnight,  it  generally takes decades and decades
of life before irreversible damage occurs.  We all know the incredible
health benefits from breastfeeding...  therefore it seems the benefit to
risk ratio sides with breastfeeding the infant,  and forgetting mom's
elevated cholesterol for some months,  maybe even a year. The risk to the
mom is extremely low,  and the risk to the bottle fed infant is much higher.
Although I seriously doubt that using lovostatin would injure a
breastfeeding infant,  I simply don't believe that 6 months of therapy will
seriously impact this mom's future. ( Nevertheless,  this is somewhat
dependent on mom's cholesterol level... if it is 500 or lower no problem,
if however it is 1000-2000 mg/dl,  thats another matter.)


        The other drug, propranolol,  is a beta blocker used primarily to
control high blood pressure and several other syndromes.  Propranolol is
poorly transferred into human milk,  and the level generally received by a
breastfeeding infant is not clinically significant.







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T.W. Hale, Ph.D.
Associate Professor of Pediatrics
Texas Tech University School of Medicine

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