I have a client currently nursing a 14 month old.  This toddler is bright
and active, breastfeeds *a lot*, but is not eating much "real food".  Mom is
very committed to continuing to breastfeed.  She has been diagnosed with a
srious fungal infection under one toenail - the toenail has lifted, and her
doctor has prescribed one 250g terbinafine (Lamisil) capsule to be taken
daily *for two months*.  However, he has suggested that the mother should
wait until the little one is weaned from the breast before taking this drug.

I have the 1999 Hale which talks about "an oral dose in two volunteers", and
describing extremely low excretion of this drug in breastmilk (page 662).
However, one oral dose in a volunteer would seem to be a whole different
thing from a two-month regimen in a real breastfeeding mom.

If possible it would be good if mom could have her treatment and if her
toddler could continue to have her breastmilk.  Does this mother have to
wait to be treated until she has weaned??  Many thanks for your help.

Pamela Morrison IBCLC
Private practice, Harare, Zimbabwe
email:[log in to unmask]

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