I received a call from a young, single mother of a 7-wk old baby. Mom had a
UTI and now has a tentatively dx "infectious diarrhea", and is being treated
with metronidazole while awaiting final identification. Mother did have
trichomonas during pregnancy, which was not treatable by this drug at that
time.........

She is on a course of 250mg 4x a day for 10 days, and has been instructed to
pump and dump. I spoke with her ped this afternoon, and while he concurs that
the reported 3mg/kg/L blood level in babies of mothers on the 200mg TID X 10
course is low, he was reluctant to give approval since the literature did not
overtly give approval. If the baby were sick, he said, he would consider the
benefits to outweigh the risks, but since she isn't........ he is "more
comfortable" staying to the "safe side" and having her bottlefeed. I did not
address the issue of benefits of breast vs artificial baby milk with the ped.


This young mother has been hassled by her bottlefeeding parents all the short
life of her baby, and has had to fight to succeed in breastfeeding. She is
worried that the baby might not take the breast at the end of 10 days, but is
also worried about breastfeeding if it might harm her baby.  We discussed cup
feeding as an alternative, but it scared her. I have given her the
information and let her know it is her decision, and she is struggling
mightily over the dilemma. Can anyone give me further input that might help
her in this decision?  I do fear that she may lose her milk supply through
this; she will have access to an EBP, but still the hassle on top of her
unsupportive family could well do her in. I am committed to helping her to
survive to the best of *my* ability.

-Lisa Marasco, BA, LLLL, IBCLC