I have a patient who has Grave's disease and who also has preeclampsia.  The
patient has been taking PTU 150mg TID and Inderal 20mg TID.  She was induced
for the preeclampsia and was on MgSO4.  She ended up with a C/S due to
failure to progress.  She is breastfeeding (and beutifully to I might add!).
 The ped was concerned about the drugs in the milk.  She said her reference
stated PTU was not compatible.  I shared my references with her (from the
AAP) and I told her that it was listed as a Category 6 (usually compatible
with BF) and that it would be safe.  She took my advice (WOW!! a small
miracle!) and "allowed" the mother to BF (her words!).  Her partner was
worried about the Inderal.  I told her that it was compatible, and that the
only complication I could see in my references was a few cases of
hypoglycemia.  I convinced her to not instruct the mother to stop BF and to
check the infant's glucose level during the hospital stay.  To this she
agreed.  The other partner was concerned about the MgSO4, I told him about
the references I had and he gave me no further problems.  Eventually the
mother will require radioactive Iodine (in December).  She says she was told
she would have to wean the baby, but I told her that she should be able to
"pump and dump" then continue BF when the levels in her blood and milk were
down.  Please help!!!!!!!
Dr. Hale, do have any more references on these drugs and can you give me a
definitive answer on the Iodine as to how long she will need to pump and
dump?

The mother sincerely wants to continue BF and is willing to do what it takes.


Jeffrey S. Fouche, RN, BSN
Breastfeeding Educator
Assistant Director of Maternal/Child Services
Barrow Medical Center
Winder, GA
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