Thanks so much to everyone who emailed to the list and to me privately about
the mother who had been prescribed the large cocktail of drugs.

After her late evening call we had arranged that she would come in for a
pump the next morning, and we would see what could be done about the
engorgement (she had said her breasts looked "purple").  I had given her the
information about the drugs as set out in the 98/99 Hale and the 4th ed of
Drugs in Preg and Lact, and relayed the paediatrician's message that none of
the individual drugs would be contraindicated, though two of them might
sedate the baby, but that he was unsure of the effect on the baby in
combination, and that it was *her* choice about whether to breastfeed, or not.

Well, she phoned very early, still very talkative and hyped up, saying that
she couldn't make the appointment because her partner had confiscated her
car keys. She declined a home visit saying she had nursed the baby for
"three minutes" the night before (after her call) and again in the morning
and that the breasts were now soft and comfortable.  I could hear the baby
in the background so he was obviously not too sedated!  She talked about how
sad she would feel to give up breastfeeding, and how "good" her baby was,
and how close she felt to him.  Seeing there was really nothing I could do,
I suggested that she *tell* her psychiatrist how much breastfeeding meant to
her, and discuss with him the possibility of receiving the treatment she
needed *and* continuing to breastfeed.  She also agreed to make an
appointment with the local paediatrician to receive first-hand info on the
likely effects on the baby of any medication . She said she would phone back
later and arrange a time to come in when her partner was home, but as it
happened she never did.

I'm sure there's a whole lot going on with this lady and far more to the
whole scenario than I have heard.  I invited her to call me when she was
ready, and conclude that I just have to leave it at that.

Thanks again to all of you who sent such good ideas and information.

Pamela Morrison IBCLC, Zimbabwe
maiilto:[log in to unmask]

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