Dear Cindy,
  I have had recent experience with a breastfeeding mom using Mesalamine.
 Baby came back into the hospital for 2-week well baby check  with profound
weight loss & greater than 20% dehydration.  Mother had been told by her
physician that Mesalamine might have some effect on her breastfeeding infant
but was unclear about the specific symptoms to observe for.  Mother was using
Mesalamine for chronic severe ulcerative colitis and found this medication
the most helpful in alleviating her symptoms.  When interviewing her about
her baby's feeding behavior, this was a classic case of Mom answering all the
right questions with all the right answers.  An over the telephone consult
would have had disastrous results.  Baby was nursing every 2-3 hrs (at least
10-12 x per day), slept between feedings, she could hear audible swallowing
with suckling, could visualize milk in baby's mouth during feeds, and the
baby was having plenty of wet diapers with stooling.  Our thoughts were that
the frequent urine & stooling were actual representation of diarrhea & not
necessarily evidence of normal output although this was only speculation.
 The baby required IV therapy for rehydration.  Because of the seriousness of
the mother's disease, breastfeeding was discontinued and the infant had no
further episodes of diarrhea or dehydration.  Unfortunately, this was the
case of a highly motivated breastfeeding mother, doing all the right things,
but who somehow failed to recognize the phsycial changes of dehyration in her
newborn infant.

This was a very interesting case & a challenge to us.  The pediatric
physicians were eager for the support of our lactation consultant team to
help them identify the impact of Mesalamine on the breastfeeding infant.

Sincerely,

Mary Lou McGee, RNC, IBCLC
El Paso, Texas