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Thread: loss of pregnancy

  1. #11
    Join Date
    Jan 2006
    Posts
    242

    Default Re: loss of pregnancy

    I have to leave in 15 minutes, and I still have no idea what to do, I know I am such a PITA!!

  2. #12
    Join Date
    Mar 2007
    Posts
    48

    Default Re: loss of pregnancy

    Quote Originally Posted by Hbsmomma View Post
    I did look at Hales and it is just so confusing. the medication is misoprostol, he says

    Here’s what Thomas Hale says about misoprostol in his book, Medications and Mothers’ Milk (2004), page 570.
    Lactation Risk Category L3 (see below for definition of L3)
    “Misoprostol is a prostoglandin E1 compound that is useful in treating nonsteriodal-induced gastric ulceration. Misoprostol is absorbed orally and rapidly metabolized. Intact misoprostol is not detectable in plasma and is rapidly metabolized to misoprostol acid which is biologically active. Secretion of misoprostol in milk is unlikely due to rapid maternal metabolism. However, secretion of its active metabolite is possible and could produce diarrhea in newborns although this has not been reported.Adult concerns: diarrhea, abdominal cramps and pain, uterine bleeding and abortion
    Pediatric concerns: none reported, but observe for diarrhea, abdominal cramps
    Adult dose: 100-200 micrograms QID
    T ½ (Half-life): 20-40 minutes
    Tmax (peak plasma interval): 14-20 minutes

    So I don't know how to interpit this, is he saying no breastfeeding or its probably ok
    I'm so sorry for your loss. I bolded the part that seemed the most important to me, but the decision rests with you and what you're comfortable with. I'm not a doctor, LLL Leader, nurse, or anything. I hope this helps.

    <hugs>
    -Jenn
    Stepmom to D (12 years)
    Proud Mom to:
    B #1 (6 years) -nursed for 18 months
    B #2 (3 1/2 years) -nursed for 2 1/2 years
    B #3 (born July 06) -still nursing!

  3. #13
    Join Date
    Mar 2006
    Posts
    10,440

    Default Re: loss of pregnancy

    From what I read from what you post, this is my take on it.

    I'm NOT an LLL leader, only a very well educated person who is quite familiar with reading drug labels and interpreting them.

    Here's what the definition of an L3 compound is: http://www.kellymom.com/health/meds/..._risk_cat.html

    So it's up to you to decide, and perhaps a leader can weigh in and help you with some more information.

    If it were me, I would probably continue and monitor my child for any GI signs. But that's me

    So sorry for your loss
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  4. #14
    Join Date
    Dec 2005
    Posts
    3,900

    Default Re: loss of pregnancy

    I'm so sorry! Let me see if I can help you with this information.

    Quote Originally Posted by Hbsmomma View Post
    Here’s what Thomas Hale says about misoprostol in his book, Medications and Mothers’ Milk (2004), page 570.
    Lactation Risk Category L3 (see below for definition of L3)
    L3 means MODERATELY SAFE: There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.

    Quote Originally Posted by Hbsmomma View Post
    “Misoprostol is a prostoglandin E1 compound that is useful in treating nonsteriodal-induced gastric ulceration. Misoprostol is absorbed orally and rapidly metabolized. Intact misoprostol is not detectable in plasma and is rapidly metabolized to misoprostol acid which is biologically active. Secretion of misoprostol in milk is unlikely due to rapid maternal metabolism.
    This means that because the mothers body metabolizes the misoprostol so fast, it is unlikely to show up in her milk.

    Quote Originally Posted by Hbsmomma View Post
    However, secretion of its active metabolite is possible and could produce diarrhea in newborns although this has not been reported.
    A newborn is a baby of 28 days or younger.

    "Intact misoprostol is not detectable in plasma and is rapidly metabolized to misoprostol acid which is biologically active." So, the active metabolite Dr. Hale speaks of would be misoprostol acid. From this writing, it appears that misoprostol would not appear in milk, but misoprostol acid *might*. This *could* give a newborn diarrhea, but that has never been reported as happening.


    Quote Originally Posted by Hbsmomma View Post
    T ½ (Half-life): 20-40 minutes
    Tmax (peak plasma interval): 14-20 minutes
    Misoprostol peaks in the blood at 14-20 minutes. It's half-life is 20-40 minutes. From this, we can gather that misoprostol would be filtered through the body by 2-3 hours.

    Here is what Dr. Hale has to say about the drug:
    http://66.230.33.248/discus/messages/72/2753.html



    More on bfing and medications:
    http://www.lalecheleague.org/NB/NBMarApr00p55.html
    http://www.kellymom.com/health/meds/medref.html


    If I can be of further assistance, please let me know.

  5. #15
    Join Date
    Feb 2006
    Posts
    1,645

    Default Re: loss of pregnancy

    He is saying that the med is an L3. I believe (and someone PLEASE correct me if I'm wrong) that means that the meds do transfer into breast milk and there is some risk associated with using it while nursing. I think that they usually say to use the L3's with caution when nursing. That being said, I have used Tylenol 3 (which I believe is also an L3) before while nursing. Have you tried calling your pharmacist?? I find that my pharmacist is sometimes more helpful than my OB or GP.

    I am soooo sorry that you're going through this.


    ETA: Guess I should have checked to see if there was a second page before responding, sorry if I posted anything in error or gave info that someone else already had!!!
    Last edited by @llli*bnbsmomma; May 11th, 2007 at 01:22 PM.
    Amber
    Mommy to Bridget (12/20/05) and Brady (9/6/07)

  6. #16
    Join Date
    Aug 2006
    Posts
    866

    Default Re: loss of pregnancy

    Here is some info on the drug safety itself....

    http://www.nlm.nih.gov/medlineplus/d...r/a689009.html

    http://www.drugs.com/cons/misoprostol.html

    I personally would not want to take it if I did not have to. I did lose a pregnancy a few years back and had a D&C completed. I was not a mother at that time but can tell you that the procedure took 45 minutes...once I woke up they made sure I could urinate and was sent home with Vicadin. I was home that afternoon. Maybe you can take this option and express milk for your LO for the day? I did not have to take too much of the pain meds prescribed. I have a decent tolerance for pain (as I think do all of us mom's who have gone through labor) and only took a couple of them, then went to good ol' fashioned ibuprofen. Me personally, I did not want to "see" the miscarriage happen and wanted it over with. This took me a long time to come to terms with..so for that I give you a big . Be strong! You can say what you want to happen when it comes to your healthcare!!!!!!!
    Leslie- Momma to Aiden 02/28/06 AND Owen 2/28/08...What timing

    Older and wiser voices can always help you find the right path, if you are only willing to listen.--Jimmy Buffet


  7. #17
    Join Date
    May 2006
    Posts
    361

    Default Re: loss of pregnancy

    I am so very sorry for your loss.
    http://thesfamilychronicles.blogspot.com

    "At the heart of motherhood is the kind of satisfaction unequalled in any other profession on earth."
    -Tina Neidlein


    Isaac- 1/1/01 Nursed only 4 months, had no idea what I was doing.
    Nathan- 4/28/03 preemie, 1 month NICU stay and still managed exclusive nursing for 6 months, better.
    Anna- 4/15/06 Self weaned just after turning 3.
    Baby girl due May 14th

  8. #18
    Join Date
    Jan 2006
    Posts
    242

    Default Re: loss of pregnancy

    Thank you all so much!!!! What a great break down of all the info. Everything is going ok. I did take the medication, and limited my daughters nursing. She seems to be doing fine with no obvious side effects of the limited nursing. I am do ok. Physically I will be fine with some time, emotionally, I am healing, and glad to have a sense of closure. I will go back in today for a blood draw, and have the ok to nurse as often as my little one wants to.

    Again thank you all soooo much. It is so wonderful to have some clear heads to describe and breakdown all the info for me.

  9. #19
    Join Date
    Jan 2006
    Posts
    1,437

    Default Re: loss of pregnancy

    I'm so glad that you and your daughter are doing well and the medication doesn't seem to be causing any problems. Be patient with yourself and give yourself time to greive. Let us know if there is anything else we can do to support you.

    Again, so sorry for your loss...

    Tiana

  10. #20
    Join Date
    Jan 2007
    Posts
    156

    Default Re: loss of pregnancy

    I don't now how I missed your original post...and all the ones that followed until now. But here's more (((hugs))) going out to you and your family. I hope you're able to put this episode behind you soon. It sounds scary as well as just plain sad.

    I'm glad your LO has been able to adjust to your reduced nursing. From what I've read, this is not a terrible drug. In adults it can cause cramping and diarrhea (usually doesn't), but like most meds, only a miniscule amount of it -- or its metabolite -- even makes it into MM, so DD should be fine. But of course it's a personal decision to nurse regularly or not. Hope you're back to your usual cuddling soon.

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