To Diane Karnbach:

        In response to your question as to whether an infant who is allergic
to Amoxycillin should breastfeed  following treatment of mom with this drug.

        My number one question is,   is the infant truly allergic to
amoxicillin,  or as is most common,  did the infant just have a skin allergy
at the same time he/she was exposed to amoxicillin.   In essence,  is the
child truly allergic to penicillin ?   Far too often,  children are declared
allergic to XXX,  when in actuality,  they just had some other unrelated
reaction.  This is very unfortunate for the child,  because it means they
can no longer use one of the most effective families of antibiotics,  which
could be life threatening sometime in the future when they may need a
penicillin.

        If you can undeniably answer this question...YES  he/she is
allergic,  then it would be unwise for the mom to breastfeed while on  ANY
penicillin.  Allergic reactions are generally Not dose related,  even
absorption of small amounts by the infant could be dangerous.

         Other suggestions for mom could include, cephalosporins(only 16%
cross reactivity),  erythromycins, azithromycin,   sulfonamides, etc.

Tom Hale






If a baby is allergic (hives) to Amoxycillin, what is the amount that is
transfered to the baby by mom taking the medication?  Should she request
another antibiotic?

TIA

Diane Karnbach, LLLL
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Date:    Sun, 3 Dec 1995 20:08:44 -0800
From:    "Lisa Marasco, IBCLC" <[log in to unmask]>
Subject: Recurrent Giardia

Hi all-- I need some input. I have a good friend who is currently
breastfeeding her 2.75 yr old toddler (29lbs) about 3 times a day-- mom
estimates that he nurses 20 minutes each side, but that only 5 minutes are
with significant swallowing. In September 94, mom had a severe case of
ghiardia and was put on metronidazole (flagyl); she pumped and dumped for
two weeks before resuming the nursing. Since then, she has had 5 milder
recurrences, but of late they have been getting stronger and more
frequent, so her ob would like to put her on flagyl again, 250 mg TID for
10 day, to try and wipe it out completely. Once again, she has been told
to avoid breastfeeding for the duration of the medication plus two days.
Given the age and size of the child, and the amount of nursing, does this
seem reasonable? Or what if she limited the nursing times or frequency a
day? I would appreciate any expert input on this.
TIA,
Lisa





Date:    Mon, 4 Dec 1995 11:16:37 -0500
From:    Dennis Ferrell <[log in to unmask]>
Subject: alprazolam

          I am working with a mom who is gradually tapering down her 2 daily
doses of alprazolam(xanax).

She had been taking this and wellbutrin thru pregnancy and was told by
Internal Medicine Md.that this should be safe thruout BF as well.

Day mom delivered,Peds told her no,not recommended(which is what PDR states)
Mom called internal med. to relay the No by baby's MD and internal
med.rescinded her safe and supports Peds based on Peds
recommendation.

If anyone has personal or professional experience with such a
situation,cares to share and Has time,please mail me at iquest.

Mom has been given info from LRB(a little red book reference authored by
Dr.Hale)and has made her decision to BF avoiding
peak hours and part of the half lives,so about twice a day.

She is currently pumping and dumping a lot,per her decision.

She is an ER nurse,never BF 2 older kids who are in High school.

My last question: What's a good approach to Peds(maintaining rapport and
courtesy and respect).Mom has appt next week and I'd
like to at least send him copies of or titles of references I have shared
with mom.

TIA
Denise FErrell,IBCLC
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