Hi all!  I have two drug safety questions.  It seems (of course) that my
sources all have conflicting information.

Phenobarbital
First is a question as to the safety of a nursing mother using
phenobarbital.  She is a "white-knuckle flier" who must take a trip soon -
by plane of course!  Her doctor knows she is bfing, as does her pharmacist.
Both said this is a good drug to help with her nerves.  (Well, first they
suggested two stiff drinks, but she doesn't drink.)  The dosage is 15 mg
tablets, take two before leaving for the airport, and another one before
boarding the plane if she is still anxious.  The same will be repeated on
the return flight.  The baby is travelling with her and will be nursing as
normal.  He is one year old but is not on solids much and still nurses 6-8
times a day as his main source of food.  I looked up phenobarbital in my
LLL "Answer Book" and it mentioned "infantile spasms after weaning from
milk containing phenobarbital, methemoglobinemia (1 case)".  Not being
medically trained, I find it confusing that both the doctor and pharmacist
said it is fine while the book mentions spasms (something that sounds not
so fine to me!).  Can someone explain this?  Is phenobarbital safe when
used this way?  She is leaving in a week, so please get back to me as soon
as you can.

Antihistimines
This same mother also has a lot of allergies - hay fever type, not asthma
or food related.  She is taking allergy shots which have helped during the
spring, but don't seem to be working as well on her fall allergies.  Her
doctor and pediatrician said taking any over the counter medications would
"dry up her milk."  However, the "Answer Book" seems to imply that some
might be fine to take (but only when she really needs them, not to take
routinely).  Is it true that some are fine to take?  Can you recommend any
that are "more fine" than others?  She lives in the States, so can get any
of the normal OTC's there.

I'm okay on most things, but find the medication aspect of breastfeeding
very very confusing.  I look forward to hearing from those much wiser than
myself in this area.  Thanks in advance for all your help!

Linda Volkovitsch, Nursing Mothers Counselor
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