I am budgeted for eight hours a week as LC (the rest of the time, I am a
staff nurse). This evening, I went to the hospital for a couple of hours
and noticed that one of the breast pumps was loaned to another unit. I went
to visit and discovered that the mom had a fever. The diagnosis was
suspected endometritis and she was on IV antibiotics.

The baby was in a crib at her bedside (which, if the mom is breastfeeding,
is somewhat common, luckily). She had been told that she had to throw her
milk away because, before hospitalization, she had taken two doses of
doxycycline. At this time, she is receiving gentamicin and clindamycin. She
asked about how long she had to wait before breastfeeding.

I looked up the meds in Hale's book. Short-term use of doxycycline is not a
contraindication to breastfeeding. Gentamicin and clindamycin are two drugs
that I have looked up numerous times before and even called poison control
because an obstetrician would not accept my sources (Poison control has
access to multiple resources, and are very helpful).

When I told her doctor that I had looked up the meds for his patient, and
given her the information, he said that clindamycin itself was O.K., but
she should definitely not breastfeed because it contained benzyl alcohol.
He did agree to look at "Medications and Mothers' Milk", but said that it
did not have current information. He referred me to the 1997 PDR. I
provided a copy of a 1994 PDR, which also listed benzyl alcohol as a
preservative. I asked him to explain the physiology of benzyl alcohol in
the mother's body, because I did not have that  much knowledge of
chemistry. I listened to him tell me about how much more information the
PDR provided than any other book. My reply was that the PDR is a collection
of drug inserts and I really found information from a professor of
pediatrics and pharmacology to be useful. (I did not go back to the mom and
tell her that she could not breastfeed.)

I have also posted Dr. Newman's article about "When Breastfeeding is not
Contraindicated" (from Breastfeeding Abstracts) on the nursery's inner
door. Many doctors repeatedly talk about being "safe" and just can't
understand why any mother would not be very happy to pump her milk for a
week and throw it out. "It's a lot better to be safe" they say. I agree. I
just think that decisions should be based upon fact, not non-thinking
beliefs.

Becky