There is absolutely no reason for a mother to have to even consider
weaning her baby if she is using these medications.  The amount of
transfer into the milk would be extremely low.

If the physician cannot be convinced, then why does he not try some
similar medications which have been used for years in high doses in
small babies--salbutamol (albuterol in US) instead of Serevent
(salmeterol) (though the advantage of salmeterol is its long action),
and beclamethasone for fluticasone (a steroid).  There may be advantages
to the newer drugs, but maybe the mother would prefer the older ones if
it did not require her to wean.  Or does the physician not consider the
mother and baby's relationship of any importance, or the risks to the
baby of sudden weaning.  Sure he does.

If I were this mother, I would use the drugs and continue breastfeeding.

Jack Newman, MD, FRCPC