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Thread: Please help: Antibiotics while breastfeeding

  1. #1
    Join Date
    Jan 2006
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    Default Please help: Antibiotics while breastfeeding

    Hi everyone,
    I am currently nursing my 15 month old. 4 weeks ago, I developed a huge lump under my arm which was very painful. I have seen 5 doctors during this time all of whom suggested ultrasound/directed me to the current doctor who is a surgeon. My present doctor said the possible reason for this could be a clogged duct and that it could have started as a mastitis. She first told me that she'd take me to the OR and do a deep Incision and drainage, which will require me to stop breastfeeding, atleast on the one side where I have the lump. I said that will be too hard on my little one since he is not into solids much. So she gave me a local anesthesia and did an incision which I have been getting packed (the packing has iodoform in it) for the last week and a half or so. This doctor is very considerate of my breastfeeding and switched me to the safest antibiotic: amoxicilin/augmentin (penicillin is considered safest i guess). Since there was not a major improvement up till the last 3/4 days, she has prescribed muscular injection of Rosephin (I have had 4 shots of it so far) along with the daily dosage of augmentin. So, I have been through 10 days of keflex, about 5 days of Cipro, and the rest of the last 2.5 weeks on augmentin. I am starting to get worried though, my 15 month old gets about 70% of his nutrition from breastmilk. Does any one have information on whether I should wean him, with so much antibiotic intake? I am hoping atleast the LLL leaders have some information. I was already worried about this, but when my mother-in-law has repeated over the phone the last couple times that I should transition him over to cows milk, it has made me more worried. Any advice, support or suggestions will be greatly appreciated.
    Sorry this was so long and thanks for reading!

  2. #2
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    Default Re: Please help: Antibiotics while breastfeeding

    Hi emerald,
    You've been through quite an ordeal! Was this a breast abscess? Have you considered talking to a International Board Certifed Lactation Consultant (IBCLC) near you? We could give you access to published information about each of those antibiotics. (I'll check back in later if that's what you would like.) Ultimately it is up to you and your health care provider to decide what is safe for you to take in your situation.
    Mary

  3. #3
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    Jan 2006
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    Default Re: Please help: Antibiotics while breastfeeding

    Mary,
    No I haven't spoken to an IBCLC yet about this, but will do. In the meanwhile, if you can check on information on these antibiotics, I will really appreciate it. My doctor says that it is just antibiotics and they give amoxicillin to children all the time. But somehow I am paranoid - even if the docs give it to children, why give it when he is healthy, kwim? I want to provide him good things with the breastmilk, but the thought that the medicines I am taking may harm him makes me very worried.
    Thanks.

  4. #4
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    Jan 2006
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    77

    Default Re: Please help: Antibiotics while breastfeeding

    Sorry, I forgot to mention. No this is not a breast abscess. If it was an abscess it would be just one big pocket and would have cleared much sooner after I&D. But this is worse - there are so many small pockets which is causing the clearing up to take much longer I am hoping for it to get better soon so that I get get back to my normal self again.....

  5. #5
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    Default Re: Please help: Antibiotics while breastfeeding

    Hi emerald,
    Here is what I found out about the medications you listed. I've put some references below. Hopefully you, your doctor and an IBCLC can tackle all this together. Keep us posted, OK?
    Mary

    Amoxicillin – Thomas Hale Lactation Risk Category L1 / AAP Table 6 “Maternal Medication Usually Compatible With Breastfeeding”
    Augmentin – Hale LRC L1 / AAP not reviewed
    Rosephin – I couldn’t find this listed in either Hale or the AAP’s list.
    Keflex – Hale LRC L1 / AAP not reviewed
    Cipro – Hale LRC L3 / AAP Table 6 “Maternal Medication Usually Compatible With Breastfeeding”

    Lactation Risk Categories - from Thomas Hale, Medications and Mothers' Milk
    L1 SAFEST:
    Drug which has been taken by a large number of breastfeeding mothers without any observed increase in adverse effects in the infant. Controlled studies in breastfeeding women fail to demonstrate a risk to the infant and the possibility of harm to the breastfeeding infant is remote; or the product is not orally bioavailable in an infant.

    L3 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.


    AMERICAN ACADEMY OF PEDIATRICS: The Transfer of Drugs and Other Chemicals Into Human Milk
    Table 6 “Maternal Medication Usually Compatible With Breastfeeding”

  6. #6
    Join Date
    Feb 2006
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    66

    Default resources for meds and bfing

    http://neonatal.ttuhsc.edu/lact/

    I believe someone already looked up this med for you but I thought I would supply a valuable resource for looking up any medication you are concerned about while bfing.

    Down the left hand side of the website you will see a medications forums... you can click here and sign in as a guest to read about meds that the professionals ask about.

  7. #7
    Join Date
    Jan 2006
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    561

    Default Re: Please help: Antibiotics while breastfeeding

    try "rocephin"

    Sounds like you have had some serious difficulty! I hope you are not in too much pain. Best of luck getting this resolved as soon as possible.

  8. #8
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    Default Re: Please help: Antibiotics while breastfeeding

    Thanks, barb.

    Rocephin is LRC L2 and AAP Table 6 “Maternal Medication Usually Compatible With Breastfeeding”

    L2 SAFER:
    Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant; And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote.


    Hale writes much more information about each medication than I've given you. And the AAP tables list "Reported Sign or Symptom in Infant or Effect on Lactation" and references. A local Leader might be willing to read the rest of Hale's information to you (it would take a long time to type!) but again, an IBCLC might really be helpful in this situation.

    HTH!
    Mary

  9. #9
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    Jan 2006
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    77

    Default Re: Please help: Antibiotics while breastfeeding

    Thanks a lot Mary, for looking up this information, and thanks Barb for the correct spelling for Rocephin. Also, Ruby, thanks for the valuable link to the medicines forum website.
    Looks like the antibiotics I have been taking are listed as safe (except for cipro which is L3 - I stopped that mid-way for fear of it not being as safe, guess that was a good thing to do). Do you know of any study on prolonged intake of even the safe antibiotics, though? That is something that still makes me worried. I'll be seeing the doctor again tomorrow, and keeping my fingers crossed. I still have the lump, but hope atleast she will take me off these painful shots. Thanks again everyone for your help - what would I do without you folks! I will keep you posted on how things go.

  10. #10
    Join Date
    Jan 2006
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    Default Re: Please help: Antibiotics while breastfeeding

    "(except for cipro which is L3 - I stopped that mid-way for fear of it not being as safe, guess that was a good thing to do)"

    Well, this brings up an interesting point. The medication cipro is listed as L3 by Hale but it's also on table 6 of the AAP. LLL Leaders are not qualified to give medical advice, make a diagnosis or tell a mother what medication is safe or not. We can provide information for mothers to discuss with their healthcare providers. The definition of L3 says "Drugs should be given only if the potential benefit justifies the potential risk to the infant." Mother and doctor working together can determine if the benefit justifies the risk.

    "Do you know of any study on prolonged intake of even the safe antibiotics, though? That is something that still makes me worried."

    It's important to discuss your concerns with your doctor. I'm glad to hear you have an appointment tomorrow. I look forward to hearing how it goes.

    Mary

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