Antibiotics & BFing

[Disco Infiltrator]

DW is fighting her third round of strep and our ND is telling us she may have to put her on antibiotics that aren't compatible with BFing.  Does anyone have stories about getting through a round of abx, having to pump and dump, putting baby on a bottle/formula while taking the abx.  Is this the end of BFing?  If DD doesn't BF for a week will she be able to start back up again?  DW is very worried.  Thx!

[KoalaMommy]

What abx is she putting her on that aren't compatible?  I've had strep while nursing.  The usual course is amoxicillan, which is totally fine for BF, another, stronger option is the zpack, which I was on when DS was born and my extremely BF friendly OB put me on knowing my due date was looming and I would be nursing.  Dr. Hale says Cipro and Doxycyclene are safe so long as the doxy isn't for more than 3 weeks, cephalexin is also fine.  That covers the majority of commonly prescribed broad-spectrum abx, which is what you would use to treat strep.  Why couldn't she use one of those?  Admittedly, abx are not ideal while nursing a babe but surely it is better than formula and than compromising the future of nursing. 

[RaeDyCo]

Have you seen the info on Kellymom?  http://www.kellymom.com/health/meds/index.html

I would highly recommend finding out the medication and calling Infant Risk to find out if there is a problem.  http://www.infantrisk.org/

Unfortunately most doctors have no idea what is compatible with breastfeeding but Infant Risk does.

[Disco Infiltrator]

She (and I) have already been on one round of Keflex (cephalaxin) and one round of erithromycin.  I should have clarified that this third round of strep is really one infection that antibiotics haven't cured and we're on our third antibiotic now.  Our ND is very knowledgeable and I trust her judgement, so I'm just hoping that the abx she ends up prescribing is compatible with BFing, but because DW has failed two rounds, we're heading into stronger abx and the possibility that they may not be.  We may be dealing with a resistant strain.

As for the Z-pack, there's a 36% reoccurance rate which is why our ND didn't give that to us.  DW has an allergic reaction to Augmentin, so that is out.  She's failed Keflex and erithromycin, so they're out. 

[KoalaMommy]

I can understand the need to knock out this infection before it gets any more resistant, however, I would still, in your situation, work with my provider to see if there wasn't an option that was compatible with breastfeeding.  In my experience, even very knowledgeable providers think more things are incompatible with nursing than actually are.  Partly because their job is to know how to treat you and your body not every mechanism of delivery and the bio-availability of every drug in human milk.  Dr. Hale, on the other hand, is a pharmacist who has made it his work to know all these issues in detail.  And even when there isn't data available, he knows the mechanisms of transfer and the properties of drugs, and can advise from and informed stance.  Your provider can pose a question to him directly here: http://www.infantrisk.com/forum/forum.php  and also review what he has said about specific abx treatments and breastfeeding in the past here: http://neonatal.ttuhsc.edu/discus/messages/40/40.html?1292693166.  One thing I notice is that Cipro, often used in persistent and resistant infections, can be taken while breastfeeding.  Now strep throat isn't an approved application of this drug, however, it is approved for skin infections, which can often be the same bacteria and it's broad spectrum.  So that might be an option for you. 

You can also read through and arm yourself with information.  In my experience, you have to know more about breastfeeding than even the most friendly providers while also trusting that they want to help you make it all work.  It is very difficult with the pump and dump strategy to make it work.  She won't pump as much milk as the baby gets nursing, she likely won't be able to pump as often as baby nursed and then there are latch questions: will baby lose the latch?

If you do need to do something that absolutely is not compatible with nursing, I'd suggest you find yourself a really awesome LC and work with her before, during and after to ensure a successful return to nursing. 

Good luck to you all.

[Disco Infiltrator]

thanks everyone - she has her prescription and we dodged a bullet - she can bf on it.  So let's hope we will now slay this nasty bug and get our family back on track.  It's been six weeks of this cr*p.