I see there is some concern about the use of Flagyl (metronidazole) to treat
a mom who has guardia.  Metronidazole is used here (200mg, three times
daily) and breastfeeding is *not* interrupted.  My 98/99 Hale says,
"Metronidazole has become the treatment of choice for pediatric giardiasis
(AAP) ...  Following a maternal dose of 200 mg three times daily, the average
absorption of metronidazole by a breastfeeding infant is reported as 3
mg/kg/500 mL intake per day which is much less than the 10-20 mg/kg
recommended therapeutic dose for infants.... Thus far no reports of untoward
effects in breastfed infants have been published for the 2 gm STAT dose, or
the 250 mg three times daily for 10 day dosage regimen."

Pamela Morrison IBCLC, Zimbabwe
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