I am working with a mother whose 10 week old baby has been diagnosed with
pertussis, as has her two year old (non-nursing, very mild case). Local health
department is involved in the situation and requested mom and baby both be
given erythromycin. Family doctor refused, saying baby is too weak/dehydrated
already and he is not willing to risk diarrhea from erythromycin causing
further dehydration.

Doctor has put both mother and baby on Septra. Doctor has advised mother to
pump and dump while she and baby are both on medication. Doctor is concerned
about drug passing into the milk in an amount significant enough to cause
overmedication of baby.

Doctor also wasn't too enthused with having to offer formula to the baby
during the interim and was very pleased to find out mother has enough frozen
breastmilk on hand to last for the next 8-10 days. Mom told doctor baby sleeps
with her and she may not be able to prevent all nighttime nursings. Doctor
said he wouldn't worry about that as long as she is not nursing during the
day.

I have looked up the information in Dr. Hale's book but did not see this
particular issue addressed. Can anyone let me know if there is a valid concern
about overmedicating baby if both mother and baby are taking Septra at the
same time? Please let me know if I need to find out the specific dosages both
mom and baby are taking.

Apparently this baby has been quite ill. Mother was told by the doctor that
her breastfeeding is the only thing that has kept her child from requiring
hospitalization. Any guidance that can be provided will be much appreciated by
both the mother and me.

Amy Shelton
breastfeeding counselor