Trish
Whether or not the mother is able to persuade a dermatologist to
prescribe Enbrel, would she be open to trying a very, very simple,
but extremely effective topical application for the psoriasis? Coal
tar solution is compatible with breastfeeding (see
<http://www.patient.co.uk/health/Coal-Tar-for-Psoriasis.htm>http://www.patient.co.uk/health/Coal-Tar-for-Psoriasis.htm
) and is usually available over the counter in several formulations
(see
<http://www.psoriasis.org/about-psoriasis/treatments/topicals/over-the-counter>http://www.psoriasis.org/about-psoriasis/treatments/topicals/over-the-counter
) I have used it for over 20 years, currently a 10% coal tar
commercially manufactured cream because that's all I can get in the
UK, but formerly a 20% solution made up by a pharmacy. Both
formulations are very effective if used sparingly on affected areas
3-4 times a day to start with, then when psoriasis is under control
can be used just once a day or occasionally when it starts to
flare. Must not come into contact with conjunctiva, and the smell is
really strong - but it works! This is an autoimmune disorder and I
have found that eliminating all bovine proteins to reduce allergens
helps a lot too - has mother recently increased dairy products in her
diet because she thinks they're good for her or the baby???
Pamela Morrison IBCLC
Rustington, England
---------------------------------
Date: Tue, 25 Sep 2012 16:36:02 -0400
From: Trisha Wierenga <[log in to unmask]>
Subject: Enbrel and breastfeeding
PTP -- mother with severe psoriasis that has been previously
successfully treated with Enbrel. Baby is 7 1/2 weeks old, EBF.
Mother's psoriasis is exacerbated after the delivery of the baby.
Enbrel is listed by Hale as an L2, no oral bioavailability, molecular
weight is 150,000. The InfantRisk Center states the medication is
safe for breastfeeding.
This mother's dermatologist refuses to prescribe the medication,
refuses to look at the information in Hale's book. He said to let him
know when she has "breastfeeding under control." Mom was very upset
with this dermatologist. The mother called all other dermatologists
in the area, and I spoke with a friend of mine that is a dermatology
physician assistant... they all say the same thing. They will not
prescribe this drug due to the FDA recommendation that "safety is
unknown." She is currently using UVB therapy without success. Her
family practice doctor and her pediatrician both feel that Enbrel
would be safe for her to take during breastfeeding, but do not feel
comfortable prescribing a "dermatology" drug.
Looking at the archives, suggestions include coconut oil,
wheat/gluten elimination, Vitamin D supplementation to help this mother.
This mother has a lovely breastfeeding relationship and does not want
to discontinue. Are there any other suggestions for this mom so she
can continue breastfeeding and get relief from her psoriasis? As it
stands now, we have exhausted her medical options for prescribing the
only drug that has helped her in the past. Thanks.
Trish Wierenga, BSN, RN, IBCLC
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
