In a message dated 05/28/2004 9:07:14 PM EST, [log in to unmask]
writes:
<< One of my friends is on Metronidazole because she had a bout of colitis.
She has been instructed to "pump and dump" for two weeks while she is on this
med. I have a nurses drug book that says the same. Her baby is a healthy
four month old. >>
Hi Shannoah,
As a nursing student I see you have already learned one valuable lesson,
most nursing and medical textbooks are lousy references when it comes to
breastfeeding, esp. as it related to medications. The best 30 bucks you can spend
is to get the 2004, Medications and Mothers' Milk, by Thomas Hale. ( I have no
financial interest in this book.) It devotes over 3 pages just on this drug,
so I can't type them all here. Excerpts are:
"In a group of 12 nursing mothers receiving 400 mg three times daily... no
adverse effects were attributable to metronidazole therapy in these infants. "
p. 555
"In another study in patients receving 600 and 1200 mg daily... the authors
estimates the daily metronidazole dose received by the infant... {as} well
below the advocated 10-20 mg/kg recommended therapeutic does for infants." p.555
"It is true that the relative infant does via milk is moderately high
depending on the dose and timing... While these levels seem significant, it is still
pertinent to remember that metronidazole is a commonly used drug in premature
neonates, infants, and children, and {dose via breastfeeding} is still much
less than the therapuetic does used in infants/children... Thus far, virtually
no adverse effects have been reported." p. 556
"'Thus far, no studies in humans have found it to be mutagenic. In fact, the
opposite seems to be the finding. Roe suggests that metronidazole is
"essentially free of cancer risk or other serious toxic side effects." p. 557
PEDIATRIC CONCERNS: Numerous studies show no untoward effects. One letter to
the editor suggests and infant developed diarrhea and a case of lactose
intolerance. The link to metronidazole is tenuous." p. 557
The challenge is that most MDs see formula as having "no untoward effects"
and so do not hesitate to interrupt both breastfeeding and a nursing
relationship thinking they are " on the safe side." This is not easy to argue with when
health professionals so seriously undervalue breastfeeding, and see formula as
a risk-free alternative.
Good luck to you and your friend.
If you want your own Hale, ( I can' t tell you how many times I use this book
each year) you can go to www.iBreastfeeding.com or call 1-800-376-1317 or
order through LLLI.
Sincerely,
Judy LeVan Fram, PT, IBCLC, Brooklyn, USA
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