In answer to Linda Volkovitsch's question re: phenobarbital and anthistamines.

    To begin with,  a one or two dose regimen is really not enough to bother
a breastfeeding infant,  even if he/she is slightly sedated.    Although
phenobarbital does transfer into breastmilk,  the total dose received by the
infant in this short span would be somewhat minimal.

        However,  I can't imagine a worse choice than phenobarbital for
flight anxiety  Phenobarbital is actually more sedating than it is an
anxiolytic(an anxiety blocker).   A better choice would probably be one from
the benzodiazepine family(Ativan, Valium, Xanax).  The benzodiazepines are
far superior  at blocking anxiety,  they are more rapid acting,  and have
shorter half-lives than phenobarbital.   Even though they too pass into
breastmilk,  a one-time exposure would probably not be unwarranted.

Re: Antihistamines

        Antihistamines are somewhat of a problem for breastfeeding moms,
because when used continuously,  many of them may produce sedation in mom
and the infant.   One non-sedating antihistamine for which we have some
reported milk levels is Claritin(Loratidine).  With this antihistamine,
only about 0.03% of the maternal dose is transferred to the infant via
breastmilk.  We do not know of the effect, if any, on the infant,  but at
least the rate of transfer appears minimal.

        One therapy that is extremely effective in most allergics,  is the
intranasal steroids(Nasalcort, Vancenase, etc).   The dose with these
products is extremely low,  so low in fact that it is difficult to even
detect plasma levels of the drug.  I think this therapy is probably ideal
for a BFing mom who has persistent problems.  She'd need to discuss this
with her allergist, or physician, to see if they would help in her specific
condition.

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T.W. Hale, Ph.D.
Associate Professor of Pediatrics
Texas Tech University School of Medicine

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