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Thread: May need to suddenly stop BF - help!

  1. #1

    Default May need to suddenly stop BF - help!

    Hello! I have an almost 4 week old little boy. I've been EBF. I thought all I had to worry about was a latch problem and some plugged ducts. Then I developed mastitis which I was fine dealing with. But that lump that wouldn't go away wasn't a duct but an abscess. I had it aspirated on Friday and it's been sent to culture. The antibiotic I was on for the mastitis wasn't doing anything so the doctor prescribed clindamycin a very strong antibiotic. He said it was reasonably safe for bf but any others he would give me would not be. I'm to take it for 10 days and it's been 3 already.

    Side effects for infant can include changes in gastro flora which means diarrhea and diaper rash. I was okay dealing with that. Then my RN mom tells me this drug is the big guns and she's worried about LO. Google says the drug can cause yeast probs so I'm worried about us getting thrush. Also says it's classically associated with c diff a serious gastro bacterial infection. Today I started having diarrhea and it's only 3 days. If it's already doing this to me what's it going to do to him? If I get c diff I could spread to him which can be fatal.

    So I'm considering switching him to a bottle of formula until I'm off meds and pumping in interim then switching back to bf. Problem is I've not pumped and he's not had a bottle. He's tried a paci and kinda takes it but often spits it out. I don't do it often. Only when his comfort sucking hurts too much - still have latch prob

    I don't know what to do. I don't know how I can quickly transition him to bottle and formula. I'd prefer to give him bottle with breastmilk then formula but his nursing sessions are so irregular and close together I didn't have time to pump in between. I worry about having to solely pump n dump. About engorgement maintaining supply whether I'll get milk. I have an ameda double electric pump. He also comfort sucks which I'm happy with but fear not being able to comfort him with nursing when he's upset. I worry abrupt weaning will hurt him. I'd be okay continuing to pump BM if necessary but don't know how to get from here to there. If I already had a pumped surplus I'd feel a lot better. The time in the day runs out so fast with a newborn. I didn't get to rest during the day. Don't know how I'm going to be able to do this so quickly.

    I battled infertility for three years and now have this precious angel. It's heartbreaking to go through this but I don't want him to suffer. I want to bring him back on the breast ASAP. This is so overwhelming.

    Please let me know what I can do and any encouragement. I'm meeting with an LC tomorrow but I need to know if this is possible. Thank you.

  2. #2
    Join Date
    May 2006
    Posts
    19,879

    Default Re: May need to suddenly stop BF - help!

    I don't see any reason to stop nursing. First of all, C. diff is quite rare in people who are generally healthy. It's most prevalent in hospitals, and you're not in a hospital. As an adult who is pretty unlikely to have any C. diff in you, you're very unlikely to get a C. diff infection even if the Clindamycin really wipes out your gut flora. Second, your baby isn't getting a full dose of Clindamycin- just what comes through your milk. Third, let's say the absolute worst happens and your and your baby's gut flora gets wiped out. In that case, the best thing to give your baby would be breastmilk, because it contains chemical compounds which help healthy bacteria get established in the infant gut (see https://pubs.acs.org/cen/coverstory/86/8639cover.html).

    I'm really sorry your mom put the fear into you. But I don't think you should worry. Just nurse the baby, take a good probiotic yourself and give one to the baby, and watch your breast hygiene and sugar intake. That should help you avoid thrush/yeast, which I see as your most likely complication from the antibiotics.

    Relax, mama! It's going to be okay! And if you're really scared, call Infant Risk. http://www.infantrisk.com
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Oct 2009
    Posts
    2,584

    Default Re: May need to suddenly stop BF - help!

    You sound very worried. I believe almost any antibiotic is safe while breastfeeding and frankly I believe the worst thing you could do for both of you would be to stop nursing.

    From Dr Jack Newman, the world's leading researcher in the field of breastfeeding . From his Facebook page, feel free to look him up, he has great info!!

    "More on drugs and breastfeeding. Why are the vast majority of drugs taken by the mother compatible with continued breastfeeding. The reason is that the amounts of drug that get into the milk are very small, only rarely enough to be of concern.

    Any drug a person takes is diluted throughout the whole body but not uniformly. Some drugs do not get into the brain easily. Some drugs are stored in the fat. However, the only way drugs can get into the breastmilk is for them to be in the blood stream, and the concentration of the drug in the blood stream is usually extremely low. As an example, paroxetine (Paxil), used to treat depression, is found mostly in the brain so that only about 1% of all the drug taken is actually in the blood stream. Amounts of most drugs are usually measured in micrograms (millionths of a gram)/ml of blood or even nanograms (billionths of a gram)/ml of blood. These are very small amounts and that means that only very tiny amounts can get into the milk.

    Very important also is the proportion of drug that is bound to proteins in the blood, since only the drug unattached to protein is available to enter into the milk. Some drugs are almost completely attached to protein. Ibuprofen (a non-steroidal anti-inflammatory drug) is over 99% bound to protein. Thus, less than 1% of the tiny amount that is found in the mother’s blood is available to be excreted into the mother’s milk. The result is that though mothers may take close to 400 mg every six hours, the milk will contain less than one (1) mg in a litre of milk. If we treated a baby with ibuprofen (for pain, for example), we would generally give 10 mg per kg of his weight so that a five kg (11 pounds) baby would get 50 mg as a single dose. The baby taking a litre of breastmilk would get only a mg or two all day.

    Again, paroxetine (Paxil), the antidepressant, is 95% protein bound so that of the already small amount in the blood (most paroxetine is in the brain and other parts of the body), 95% will not be available for transfer into the milk.

    In other words, the majority of drugs do not get into the milk in quantities that should make us worry about negative effects on the baby’s system. The real question is: which is safer for the baby, breastfeeding with tiny amounts (often vanishingly small amounts) of drug in the milk or artificial feeding? Or in the case of an older baby/toddler, forced weaning from the breast of a baby for whom, besides breastmilk, breastfeeding is stability, warmth, comfort and love?"

    I would not pump and dump. I would not quit nursing. You are doing great. I personally took antibiotics while breastfeeding with no ill effects to my babies.
    Nursed my sweet daughter 3 years, 3 mos.

  4. #4
    Join Date
    Sep 2012
    Location
    rockford,il
    Posts
    456

    Default Re: May need to suddenly stop BF - help!

    http://www.breastfeedingmums.com/dr_..._mastitis.html
    Another article from Dr Jack Newman recommending the antibiotic you're on as preferred for mastitis. If you're worried about gut health, start a probiotic and try for healing foods like homemade broth and fermented foods.
    I took the same meds three weeks pp with no ill effects on ds.

  5. #5

    Default Re: May need to suddenly stop BF - help!

    The Academy of breast-feeding medicine also has an excellent article on breast infection, treatment and breast-feeding.

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