I have a mom that I need some help with.  I am especially needing help from
the physicians out there.
This mom is 8 weeks pp who had hyperemesis throughout her pregnany.  Now 8
wks pp she is admitted with pancreatitis and gallstones.  Probably the cause
of her hyperemisis.  She is jaundice from her eyes to her feet.  Her bili is
8 (I am used to babies with much higher but the docs seem real amazed that
hers is that high).  Her other lab values are as follows.
Lipase      7668
Amylase   1666
Alk Phos   1631
AST/SGOT 449
SGPT/ALT  463
The surgeons did not want her to pump but I convienced them that if she did
pump she would get even sicker and they would be dealing with mastitis and
possibly abcesses.  They finally agreed but now they are saying she must
pump and dump.  First reason was because of the meds she is on.   She is on
Cefotan.  Dr. Hale lists this as an L2 with a MW of 576 with poor oral
absorption.  She is also on Protonix.  The pharmacist in the NICU did some
figuring and said that from his info, and the info from Dr. Hale, that the
amount of meds that might get to the baby was "nonconsequential".  (His
words)  Now they are saying that she can't save her milk because of her lab
values.  I have looked through Dr. Lawrence's book as well as Riordan and
Auerbach (My 2 bibles lately as I prepare for the test on 7/27).  I can't
find any reason that mom can not save her milk.  I have her calling her
pediatrician as he is in another town.  I somewhat understand why they don't
want baby on the surgical floor as that could expose baby to infection but I
am not convienced that they can not pump and give the milk to the baby.  I
suggested mom go to the mother/baby floor so she could keep the baby but if
they aren't willing to let her bf then they see no reason to do that.
I would appreciate any help you could give me.  Is moms illness cause for
her to pump and dump?
TIA,
Debra Knight, RN, ICCE, CLC
And hopefully IBCLC after testing 7/29/02

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