when meds force weaning - help me find a creative solution

[saraem]

My 17 month old was happily nursing on demand until last week, when I was prescribed Doxycycline for suspected early Lyme disease (found an embedded tick and removed it promptly, but had fever and headache a week later).

I was told I would have to wean immediately but through my own research and consulting with my midwife, found that a 3 week course would be ok. I have weaned him down to nursing twice daily, so I take the abx right after he nurses and that way the drug is at it's lowest concentration in my body when he nurses. This would be a great solution except that I have to take the Doxy for 30 days, not just 3 weeks :(

Has anyone dealt with this? I am allergic to penicillin so amox (the other thing they use to treat Lyme) is not an option, and this is not something I feel I can mess around with.

I am considering trying to get pumped breastmilk from a friend (I gave away my 300+oz freezer stash when we moved across the country a few months ago) to use for the 9 days additional time I need to take the meds, but I am not sure that will even work. He will and has taken a bottle, but it's definitely not interchangeable for him. I would pump and dump to keep up my supply.

Will he forget how to nurse in that time?

Does anyone have any other ideas or solutions? I just don't feel like he's quite ready to wean and hate to have to force the issue.

[PatioGardener]

Have you spoken to anyone at www.infantrisk.org? They may have some good ideas.
 

[saraem]

Originally Posted by PatioGardener 

Have you spoken to anyone at www.infantrisk.org? They may have some good ideas.
 

I will call them tomorrow. I'm also wondering if I eliminate the morning feeding now, I can continue just the nighttime feeding for 30 days. I don't know whether that would ultimately add up to the same exposure or if the exposure (even at a lower level) over a longer time period is the issue. There just isn't that much info readily available.

[katelove]

According to Hales a 3-4 weeks course is ok. Four weeks = 28 days so I would say its up to you whether you're ok with the extra two days.

[PatioGardener]

I haven't spoken with anyone at infantrisk, but it does seem like Thomas Hale tries to weight the risks (as they are known) of continuing to breastfeed with the medication vs the risks of discontinuing breastfeeding. For a toddler, there isn't much known about the risks of not breastfeeding, as the research just hasn't been done.

For me, I know that weaning my DS now (he's 24 months old) would be extremely hard on him emotionally, and would impact his physical health too as he is in day care, and breastfeeding keeps hydrated when he gets a stomach bug. I'd have to balance the risk of losing the good things vs the risks of having the medication in my milk vs some middle ground with reduced nursing (and I'd probably pump to keep up my supply, although I hate the thing.)

I hope that infant risk can give you some really good information, and that there is a way for you to continue nursing your little one. Good luck!

[saraem]

Originally Posted by katelove 

According to Hales a 3-4 weeks course is ok. Four weeks = 28 days so I would say its up to you whether you're ok with the extra two days.

Where did you find that info?  I have only seen him comment on 3 weeks, not 4, but I don't have the actual book on hand, I am just reading snippets on the internet.

[saraem]

Originally Posted by PatioGardener 

I haven't spoken with anyone at infantrisk, but it does seem like Thomas Hale tries to weight the risks (as they are known) of continuing to breastfeed with the medication vs the risks of discontinuing breastfeeding. For a toddler, there isn't much known about the risks of not breastfeeding, as the research just hasn't been done.

For me, I know that weaning my DS now (he's 24 months old) would be extremely hard on him emotionally, and would impact his physical health too as he is in day care, and breastfeeding keeps hydrated when he gets a stomach bug. I'd have to balance the risk of losing the good things vs the risks of having the medication in my milk vs some middle ground with reduced nursing (and I'd probably pump to keep up my supply, although I hate the thing.)

I hope that infant risk can give you some really good information, and that there is a way for you to continue nursing your little one. Good luck!

Exactly. I felt really good about choosing the middle ground (esp knowing we could always ramp back up after I was finished with the meds) until I realized that the course I have to take is longer than I've seen Hale ok. My ODS nursed until 27 mos so this feels way early to me.

[katelove]

Originally Posted by saraem 

Originally Posted by katelove 

According to Hales a 3-4 weeks course is ok. Four weeks = 28 days so I would say its up to you whether you're ok with the extra two days.

Where did you find that info?  I have only seen him comment on 3 weeks, not 4, but I don't have the actual book on hand, I am just reading snippets on the internet.

I subscribe to Hales via skyscape for my job :-)

[saraem]

Originally Posted by katelove 


I subscribe to Hales via skyscape for my job :-)

Still can't find info listing 4 weeks as safe. I am seeing him say avoid Doxy if longer taking longer than 3 weeks: http://www.infantrisk.com/content/antibiotics-and-breastfeeding

[Subhuti]

Oh, momma, I feel for you.  Especially as a mom who's had lyme -- you do HAVE to take care of it and 4 weeks is the minimum w/an embedded tick.

Not to scare you -- but have you ruled out that the bacteria doesn't get transmitted by breast milk?  I've never heard that it has, but I would want to rule it out.  Those little lyme buggers get into everything -- they got into my brain.  

I did eventually get rid of it entirely, but (because I had very delayed treatment) it took two years.

Best of luck ~  hope you can preserve your nursing somehow.  Your babe is so young!

[Subhuti]

BTW, just checked, the CDC unequivcally says NO lyme is transferred during breast feeding.

:)

[saraem]

Originally Posted by Subhuti 

BTW, just checked, the CDC unequivcally says NO lyme is transferred during breast feeding.

:)

That's what the CDC says, but I'm not entirely sure that's true. They have found DNA from Lyme in BM, but whether it is from the mother's immune response or otherwise is not yet known. There is anecdotal evidence of Lyme being transmitted via BM, but no studies have shown this to be true. I have weighed the risks and benefits of weaning and have decided to continue to nurse, if possible, because I think the risk of transmission is low since it was caught early and treated, and I think that he will benefit greatly from the immune protection breastfeeding offers.

That said, unless I can figure this out soon I will have to wean as I don't feel comfortable continuing past 3 weeks treatment without some more concrete evidence that this is ok. Infant Risk is not answering the phone today, I get a generic recording and then am disconnected :(

[katelove]

Originally Posted by saraem 

Originally Posted by katelove 

I subscribe to Hales via skyscape for my job :-)

Still can't find info listing 4 weeks as safe. I am seeing him say avoid Doxy if longer taking longer than 3 weeks: http://www.infantrisk.com/content/antibiotics-and-breastfeeding

Is that Hales? I'm not familiar with that site. This is the quote from Mothers Milk which I access via an iPhone app called skyscape

"short term use (3-4 weeks) is not contraindicated."

Sorry I can't link it as its not on the web.

[saraem]

Originally Posted by katelove 


Is that Hales? I'm not familiar with that site. This is the quote from Mothers Milk which I access via an iPhone app called skyscape
"short term use (3-4 weeks) is not contraindicated."
Sorry I can't link it as its not on the web.

Yes, InfantRisk is associated with Hale. He has a new iPhone app by the same name.

[Super~Single~Mama]

If you aren't comfortable nursing past 3 weeks on the medication, why not stop nursing for the last week, and see if your child still wants to nurse. I'm a single mom, and my ds went on week long visits with his dad before weaning, and still nursed afterward (granted I was not available to nurse during that time, so wasn't saying "no"). It's not a given that your child would completely wean after a one week break, and I think you should definitely follow your instincts when it comes to medication that could be harmful to your LO.