I have a question for pediatricians and pharmacists (Jack,Tom or anyone
else who can help).  I have a mom with a seizure disorder on phenobarb
who was told 7 years ago that she could not breastfeed due to the
medication.  She just had her second baby (both babies have spina bifida
which is another story and very sad).  She is breastfeeding here in the
hospital and baby is having difficulty latching but is getting her milk.

Hale's book states that phenobarbital should be administered with caution
and close observation of the infant is required including plasma drug
levels.  How soon should levels be checked and how often?  What is an
acceptable level in the baby?

 This baby is very drowsy and not real interested in eating.  He's a week
old and has already been through major surgery to close his spine.

I have told the mom that the baby needs to be monitored for sedation
from the phenobarb.  Am I correct that it's not contraindicated?

TIA.

Rachelle Lessen, RD, IBCLC
Philadelphia, PA   USA       mailto:[log in to unmask]