Can someone please help me with this?  I tried Dr. Hale's site, and the drug info pages are not up right now.  I also tried a search of the LactNet archives, and didn't turn up anything.

My sister is nursing an 11-month old, approximately 19 pounds.  The baby is currently taking antibiotics for an infection in her ears & nasal passages following a bout with nasal allergies and profuse mucus.  Mom has severe diarrhea and became very dehydrated.  Was seen in the ER and given fluids & electrolyes by IV, and a scrip for Lomotil, which contains diphenoxylate and atropine.

The drug monograph says to use caution with Lomotil for nursing mothers.  The metabolite of diphenoxylate, diphenoxylic acid, is extreted in breastmilk.  Specifically, it is not indicated for children under the age of 2 years, because of depressed respiratory function.

Mom's milk supply has dropped and she's expressing regulary but not getting much.  Baby is nursing sporadically, and has nearly depleted her stock of frozen milk.  She's taking acidolphilus to help her gut, and has fenugreek on hand, which has helped with supply in the past.

Any ideas?  Concerns?

Debbie McCallister
Louisville, KY
LactNet Lurker

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