Question for anybody with knowledge about medications for glaucoma:
Some of you may remember this patient. I have been counselling a 30y-old
woman with a 16 month old boy. She was diagnosed with glaucoma when the
baby was just a few months old. The opthamologist told her to wean, but
because of all of the help we got here and from Dr. Hale's book she has been
breastfeeding all along. The doc. has tried several meds during the last
year and is not satisfied with the pressures in her eyes yet. At this point
here is what she is taking:
Timoptic 1.5 , l drop in each eye once a day (AAP approved, pg. 640 in
2000 edition)
Xalatan l drop in each eye once a day (not reviewed by AAP - but according
to Hale, "untoward effects via milk are unlikely", pg. 381 in 2000
edition)
Because she is nervous about her baby's health, she has always waited a few
hours after administering the drops before nursing. And because the doctor
has been very very unsupportive of nursing, she has been not been telling
him the truth. For at least 5 or 6 months she has told him that she has
weaned the baby. In fact, the baby is quite a nurser and probably takes in
more breastmilk than any one other food. He is very healthy, too, as you
might have guessed, and we have never been able to observe any effects in
him such as sedation, depression or others mentioned in Hale.
Now the doctor is telling her that the pressures (which linger around 21)
are still too high and he wants to try something else or to increase the
doseage of these same drugs.
With her permission, OUR QUESTION IS: Is it possible that breastfeeding
could have anything to do with the pressures not decreasing as much as the
doctor expects with these medications? I cannot imagine that this is the
case, but we are stumped.
And, MY QUESTION IS: Is 21 a high pressure? I think at the peak her
pressures were around 27 or 28.
Any insight you could give us would be appreciated. Feel free to post to the
whole list, but please also send me the answer privately. Thanks very much,
libby Berkeley, MPH, CHES, [IB]CLC
El Paso
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