Kim:  I wonder whether the doctor has tried her on erythromicin at all.
If not, this would certainly be preferable to a drug whose effects are
not known (by the way, zithromax (azithromicin), now has a pediatric
indication, but I don't think for infants).  By the way, the other
commonly used acne medication is tetracycline and its derivatives such as
doxycycline and minocycline.  The tetracyclines are contraindicated in
pregnancy and in childhood because they cause brown staining of teeth and
brittleness of bones.  However, tetracycline (but not its
derivatives) has to be taken on an empty stomach and especially without
any milk products, because it binds to calcium in a way that prevents its
absorption.  Tetracycline gets into human milk, but because it is bound
in this way, it has been shown not to be absorbed at all by the baby.
Tetracycline may be a drug that this mother's doctor was avoiding because
it is so contraindicated in pregnancy and in children.  Perhaps he/she
was not aware that it poses a negligible risk in breastfed babies.  The
AAP considers it compatible with breastfeeding, Briggs concurs and Dr.
Hale states that it is compatible with nursing for short term.  Alicia.
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