I am interested in Dr. Hale's comment about one case of
pseudomembranous colitis in a baby whose mother received
ciprofloxacin.  I am not aware of how they proved that the baby had
pseudomembranous colitis and that this was due to ciprofloxacin, but I
accept it as possible.  But I do know of the one case of beta blockade
which occurred in a baby whose mother receive atenelol.  This drug, at
least in Toronto, is considered contraindicated during breastfeeding
because of this one case, even though I am aware of many mothers who
took atenelol without any apparent effect in the baby.

However, I have personally seen children who have gotten severely ill
and even died after taking cotrimoxazole (Septra, Bactrim)
(Stephen-Johnson Syndrome, or severe gastroenteritis) and I have never
heard anyone say *that* stopped them from dispensing these drugs in
children.  And not only cotrimoxazole, but also any antibiotic and
almost any drug for that matter.  I use antibiotics as examples,
because, I'll tell you all a secret, most children who get antibiotics
don't really need them.  It would seem that it is only if the babies
get sick because of the drug coming through the milk instead of
getting the drug directly that we get so concerned.  One case report
in the world is enough.

Comments?

Jack Newman, MD, FRCPC