I would like to introduce myself to fellow lacnetters. My name is Jeannette
Newman-Velez. I   work  for the  YWCA  WIC Program in Sacramento, CA as
Breastfeeding Promotion coordinator. I am a Registered Dietitian and have now
been I.B.CLC. for 1 year and learning more each day . I have two children.
Lactnet has been a great way to problem solve for difficult cases. I just wish I
could read my mail faster!

I submit these questions on behave of  a fellow  I.B.C.L.C. and friend not
currently hooked-up with Lactnet. She  hopes that national or international
sources may have more experience with this situation. Her client is on meds
for Malaria. Mom is 5 weeks  postpartum., primipara. This is her third bout with
Malaria. Baby is getting some ABM  as well as EHM supplied by a close friend who
is also BF'ing a newborn. Mom took  Mefloquine for 24 hours and now taking
weekly(?) doses of Primaquine.  Mom is pumping to maintain milk supply until
meds are at a safe level in her milk. M.D.  supports mom's desire to BF.

 In  Briggs "Drugs in Preg & Lact." 5th ED. no data is available on Primaquine's
risk to infant during BF or its half-life..

Re: Mefloquine Brigg states" Long-term effects of mefloquine exposure via breast
milk have not been studied. because the antimalarial agent has a long plasma
half-life averaging 14.4- 18.0 days during and after lactation, weekly
prophylactic doses of mefloquine will result in continuous exposure of a nursing
infant. Moreover, higher milk concentrations of mefloquine than those reported
should be expected after therapeutic or weekly prophylactic doses."
Questions:

1)How long should mom pump and dump after primaquine TX stops before she     can
safely give her baby her   HM again ?  Should one assume that its half-life is
    similar to mefloqouine?

2)  What is the protocol for Bf'ing during Malaria TX  in other countries where
     Malaria is more common?.

3)  What laboratories in U.S. will test breastmilk for Primaquine or other
     prescription drugs levels;  and what do they charge for services. The labs
my
     friend has contacted only test for illicit drug levels.


Thank you in advance (TIA)
Jeannette Newman-Velez, R.D., M.P.H., I.B.C.L.C.
[log in to unmask]