Breast feeding and antibiotics

[Kerileanne99]

I spent all last week with a really miserable case of the flu (in August!) and then yesterday was diagnosed with pneumonia. Of course hubby is really busy this week with students and exams durning finals week at the uni:(

Anyway, they loaded me up with antibiotics and breathing treatments, and sent me home with more antibiotics and inhalers. But in reading about the specific antibiotics I am not at all sold on the idea of passing them to my 4 month old baby! Who is on antibiotics of his own for dual ear infections:(

 

Normally I would just pump and dump, then feed him from reserves and formula...but all the poor thing wants is to nurse because his ears hurt and he had vaccinations yesterday.

Anybody ever done this?

Specific antibiotics are SMZ/TMP (Bactrim) and Doxycycline ....

[Ellie]

:grouphug:

 

Well, the thing is, if you want him to continue to nurse past four months, you need to nurse him now.

[zoobie]

Dr. Hale is the expert. I tried to phone Google, but my 14 mo old is nursing and trying to kick it out of my hand... This is the best link I could scramble http://www.aafp.org/afp/2001/0701/p119.html(scroll down down down for Bactrim then...wham! Phone flew...)

 

If Dr. Hale says they're ok, I would take them and continue breastfeeding. But I would be taking and giving really good probiotics (carefully timed for you so they don't fight!) and digestive enzymes. I hope you feel better soon. :grouphug:

 

If they're not ok (Bactrim should be), call and get a compatible med. Your milk will pass along antibodies to protect the little guy from pneumonia too!

[Bluegoat]

I think people are far too inclined to pump and dump.  It's rarely required.  If you want to look into your medications more specifically I would recommend Dr Newman's website. 

 

I would be more inclined to question giving antibiotics for an ear infection.  Usually that is not appropriate - most are viral. 

[Kerileanne99]

Dr. Hale is the expert. I tried to phone Google, but my 14 mo old is nursing and trying to kick it out of my hand... This is the best link I could scramble http://www.aafp.org/afp/2001/0701/p119.html(scroll down down down for Bactrim then...wham! Phone flew...)

 

If Dr. Hale says they're ok, I would take them and continue breastfeeding. But I would be taking and giving really good probiotics (carefully timed for you so they don't fight!) and digestive enzymes. I hope you feel better soon. :grouphug:

 

If they're not ok (Bactrim should be), call and get a compatible med. Your milk will pass along antibodies to protect the little guy from pneumonia too!

Thanks, this is what I spent 30 minutes searching for. It specifically says Doxycycline should be avoided as it causes permanent staining of teeth (even in infants without!) and decreased bone growth:(

 

Yes, his pediatrician told me it was likely that passing my antibodies to him was the only reason he is not more ill:)

[Kerileanne99]

I would be more inclined to question giving antibiotics for an ear infection. Usually that is not appropriate - most are viral.

I am not fond of giving him antibiotics either. Dd5 has a history of ear infections and we typically let it go unless she is in a lot of pain. Especially since she is allergic to the common antibiotics used to treat them. However, in this case they KNOW my illness is bacterial in nature and he hasn't left the house or been around anyone for nearly 2 weeks. Also, there are some physical anomalies in his tubes which make treating now a better bet, according to his pediatrician. Oh, and he is really miserable. His little tubes won't even allow the drops for pain to get through:(

[ocelotmom]

:grouphug:

 

Well, the thing is, if you want him to continue to nurse past four months, you need to nurse him now.

 

I'm not sure what you are trying to say here. That she should just nurse the baby regardless of potential side effects? Or not take the antibiotics she's been prescribed for a life-threatening infection? She's clearly trying to find an answer that will let her continue breastfeeding.

 

Bactrim is prescribed to infants directly, so it should not be a concern.

 

Doxycycline is, according safefetus.com, considered appropriate for breastfeeding. My drug guide says that it should only be used in breastfeeding mothers for life-threatening conditions when there is no good alternative due to the concern about tooth staining. Another site says that it's generally considered safe for courses of 14 days or less. If you feel uncomfortable with it, there are other antibiotics that are considered safer for breastfeeding, and you can ask if there is a good alternative. 

 

And yes, thrush is probably the biggest concern, so probiotics are a good idea.

[carriede]

Did you doc know you're bfeeding? Call the nurses line and ask for a gentler script.

[mellifera33]

I'm surprised that your doctor prescribed doxy for a nursing mom. I am supposed to take a course of doxycycline for a chronic condition (not for its antibiotic properties, but because one of the side effects is that it causes the layers of the cornea to stick to each other more effectively--weird) and I have to wait until I'm not pregnant or nursing. I've been waiting about six years now. Can you call your doctor and ask for a substitute?

[carriede]

Did you doc know you're bfeeding? Call the nurses line and ask for a gentler script.

[Kerileanne99]

Did you doc know you're bfeeding? Call the nurses line and ask for a gentler script.

Yes. In fact I had to feed my son (he is still so new I get a thrill just typing those words!) while I was having the breathing treatment in the office.

[Daria]

Bactrim is prescribed to infants directly, so it should not be a concern.

 

 

Bactrim is prescribed directly to infants, because sometimes infants are very sick, or at high risk, and it's needed.   

 

DS was prescribed Bactrim at 2 months, for good reasons, but his doctors recommended regular bloodwork to look for side effects.  In DS's case, he reacted with severe silent reflux, which damaged his upper airway to the point that he needed a feeding tube to prevent aspiration.  When we saw the specialist who prescribed it he acknowledged that they often see GI side effects from it, and many infants aren't able to tolerate it.  

 

I have no idea if it passes through breastmilk, so it might be safe, but I'd be very hesitant to give Bactrim to my infant, unless there was a very powerful reason to do so.  

[staceyobu]

Anybody ever done this?

Specific antibiotics are SMZ/TMP (Bactrim) and Doxycycline ....

 

I have the Infant Risk app on my phone. It gives the latest info from Dr. Hale's Infant Risk Center.

 

Bactrim:  L3 (limited data - probably compatible)

 

Probably Safe. Sulfamethoxazole and Trimethoprim is a combined drug product used as an antibiotic in the treatment of various infections.  Sulfamethoxazole is secreted in breastmilk in small amounts. Use with caution in mothers with weakened infants, premature infants, or neonates with hyperbilirubinemia, or in mothers with newborn infants (first 22 days). Trimethoprim apparently poses few problems in full term or older infants where it is commonly used clinically but its long-term use should be avoided in breastfeeding mothers.  The relative infant dose of trimethoprim is 4-9%.  Since this combined drug product may increase the risk of hyperbilirubinemia in newborns, caution recommended first 30 days postpartum. Probably quite safe in full-term and older infants.  

 

 

Doxycycline: L3 (limited data - probably compatible)

 

Probably Safe/ Possibly Hazardous if used chronically.  Human studies in breastfeeding women are not available or if available demonstrate only minimal to no adverse effects. It is well-known that tetracyclines as a class tend to stain the teeth yellow after prolonged exposure.  Doxycycline is the least staining of the tetracyclines, and short-term usage should be fine.  Prolonged exposure may lead to impaired bone growth and increased likelihood of staining.  Treatment for up to 3 weeks is acceptable in breastfeeding mothers.

 

For more information, you can contact the InfantRisk Center at 806-352-2519

 

 

Hope you guys are both feeling good again soon!!!

[staceyobu]

Just a few additional notes on this thread... medications pass through milk in varying degrees, or not at all.  Usually it is a very small percentage.  Long term dosages of medication are much different than short term dosages of medication.  Taking an antibiotic while pregnant can be much different than taking one while nursing a newborn, which can be much different than taking one while nursing a two year old. 

 

Pumping and dumping is sometimes (but very, very rarely) necessary.  And is a much better solution than ending the breastfeeding relationship.

 

Pumping and dumping is not ideal.  Moms often see a supply decrease when pumping only.  Baby loses out on the antibodies that breastmilk provides.  Baby misses out on the comfort he has become accustomed to.  Mom is faced with a chore while simultaneously dealing with sickness.  

[Kerileanne99]

Bactrim is prescribed directly to infants, because sometimes infants are very sick, or at high risk, and it's needed.

 

DS was prescribed Bactrim at 2 months, for good reasons, but his doctors recommended regular bloodwork to look for side effects. In DS's case, he reacted with severe silent reflux, which damaged his upper airway to the point that he needed a feeding tube to prevent aspiration. When we saw the specialist who prescribed it he acknowledged that they often see GI side effects from it, and many infants aren't able to tolerate it.

 

I have no idea if it passes through breastmilk, so it might be safe, but I'd be very hesitant to give Bactrim to my infant, unless there was a very powerful reason to do so.

Oh wow, how frightening for you! I hope he has recovered.

 

I have a call in to the Dr.'s office to see if they can reexamine the situation.

[Love_to_Read]

I would call the doctor (doctors?) back to discuss safer alternatives, see if they can switch your prescription to something better.  I don't think it would be wise to skip them given how sick you are, nor to stop nursing, but there are safer medications on the market.

 

I'd also stock up heavily on acidophilus capsules, because the two of you are likely to end up with a raging yeast infection. Babies often get it as thrush in the mouth, and that can make nursing painful for both of you.  You'll want to take the acidophilus spaced out at different times than the antibiotics (well, double-check with doc to be sure it won't harm the effectiveness of the abx, but for less-serious illnesses I've always been able to take them halfway between doses) and you'll want to take them for a couple weeks after the abx are done.  Newman's site linked above gives some more detailed info about fighting thrush...just be aware and do what you can preventatively...go heavy on the probiotics and try to avoid sugar/wheat if possible while your body is dealing with the abx. 

[mommymilkies]

I get chronic UTIs and had abx after surgery while breastfeeding.  Dr. Newman or Dr. Hale are great resources!  And never be afraid to ask for an alternative antibiotic.  I'm allergic to a few, so I always have to, anyway.  

[Kerileanne99]

I would call the doctor (doctors?) back to discuss safer alternatives, see if they can switch your prescription to something better. I don't think it would be wise to skip them given how sick you are, nor to stop nursing, but there are safer medications on the market.

 

I'd also stock up heavily on acidophilus capsules, because the two of you are likely to end up with a raging yeast infection. Babies often get it as thrush in the mouth, and that can make nursing painful for both of you. You'll want to take the acidophilus spaced out at different times than the antibiotics (well, double-check with doc to be sure it won't harm the effectiveness of the abx, but for less-serious illnesses I've always been able to take them halfway between doses) and you'll want to take them for a couple weeks after the abx are done. Newman's site linked above gives some more detailed info about fighting thrush...just be aware and do what you can preventatively...go heavy on the probiotics and try to avoid sugar/wheat if possible while your body is dealing with the abx.

Thanks for adding to my mental misery:)

No, really, thanks. This is a good idea. Baby is on probiotics now.

 

I am waiting on a call from the Dr. The nurse did say it is complicated because I am allergic to some of the other contenders:(

I just want it to go.away.now. Failing that, right now I would settle for the huge aching spot on my butt where they gave me the most painful of painful antibiotic injections yesterday. It happens to be RIGHT where I sit in the wheelchair:(.

It's always the little things that tip me over the edge, lol.

[Love_to_Read]

I'm so sorry!  But seriously, it was right around 3-4mo that we got thrush from a round of abx for ear infection/respiratory infection, and I'd give anything to have known to start throwing probiotics at it asap before the yeast symptoms started.  Maybe you'll get lucky since you're already feeding them to baby.  Do treat yourself, too, though, you'll be glad you did.

[Daria]

Oh wow, how frightening for you! I hope he has recovered.

 

I have a call in to the Dr.'s office to see if they can reexamine the situation.

 

I didn't mean to scare you.   My guess is that if they prescribed Bactrim they're concerned about your health, and of course your son needs a healthy mom.  If other people are telling you that Bactrim is safe while nursing, I'm not disagreeing, I don't have any information about whether it passes through to the baby or in what quantities.  I was just mostly responding to the idea that just because a medication is sometimes used with infants, it must be safe for infants.  Sometimes it's just safer than the condition it's treating.