I tried to post to Dr. Hale's forum, but it doesn't seem to be working for me.  
(Very possibly user error!)  Can anyone give me info regarding the drug 
Cerebyx (fosphenytoin)?

Cerebyx converts rapidly to phenytoin, so I have been reading the info 
regarding phenytoin in Hale. The information for Phenytoin addresses its safety 
in mothers who are receiving doses of 300 - 600mg daily, and I assume that 
these are long-term doses in mothers with mature milk. I need info regarding 
safety when the medication is given in high doses for a short term period 
during labor and early postpartum. 

In our hospital, Cerebyx is given to mothers IV, with the intent to keep 
therapeutic blood levels of 13-15 for 24 hours. Generally (depending on length 
of labor), 1-2 doses of 0.7g are given during labor, then another dose of 0.7g 
is given 12-15 hours after delivery. This results in anywhere from 700 to 
2100mg within a 24 hours period. 

Our current policy is to pump and dump during treatment and for 24 hours 
after the final dose. Would it be safe for infants to consume their mothers 
colostrum during therapy? If not, how long should we continue discarding 
colostrum after discontinuing therapy?  

Thank  you,
Julie Conaway, RN, IBCLC
Rolla, MO USA

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