"Big Gun" Antibiotics and possibly having to wean my 10.5 month old - Mothering Forums

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Old 09-26-2012, 10:46 PM - Thread Starter
 
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Basically, I had a broken and ingrown toenail in my big toe that I ignored for quite awhile. I won't go into all of the details, but I finally found a podiatrist and have been seeing him weekly for the past month. In that time I have had 3 minor surgeries, first a partial nail avulsion to remove sides of toenail and chemically burn them and then two follow-ups (I&D) because the infection surrounding my nail is not going away. I have been on three different antibiotics (first Cefprozil, then Bactrim, then back on Cefprozil, now Augmentin for the past week). He finally cultured it and said what I have (Enterococcus) was shown to be sensitive to the Augmentin... but I've been on it over a week and my toe is not improving.

 

I have a decent amount of medical knowledge (second-year nursing student) and have seen lots of nasty foot infections at the hospital, which is why I am so concerned about this. I am worried that what I have may have been acquired from the hospital :(  My podiatrist said if Augmentin doesn't work, I'm looking at either IV Vancomycin with a PICC line (eek) or the oral option is linezolid (Zyvox). Problem with Zyvox is that it can be very expensive ($100+/pill) and insurance might not cover it... He said Vancomycin may end up costing me more with the need for home health and a PICC line insertion, etc. But my insurance company will not likely cover Zyvox unless it's VRE and supposedly what I have is susceptible to Vanco. I started researching and found another possible drug to ask him about - Daptomycin, which may be safe to breastfeed with, but it also looks like it's an IV drug and is significantly more expensive than Vancomycin. We are not exactly rolling in the dough right now...

 

My baby has had no adverse effects from any of the antibiotics I've taken so far, but I don't know if I want to risk exposing him to these nasty drugs. I don't think I would feel comfortable nursing while taking Vanco or Zyvox. My baby is 10.5 months old and still mostly breastfed. He doesn't take much solid food although we're working on that. We co-sleep and he's a frequent night nurser as well. He breastfeeds on demand, but when I'm in school on the weekends he takes a bottle and I pump. I'm willing to "pump and dump" if the course of antibiotics is <2 weeks, but I know it will be very hard on him regardless. I exclusively pumped with my first child for 10 months and I am not willing to pump for longer than 2 weeks or so... call me selfish but I have so much going on I can't commit to that.

 

I still have another week to give this Augmentin a shot and I am following all of the instructions precisely (wound care twice a day, keeping area dry, taking my antibiotic twice a day). Also taking probiotics and trying Grapefruit Seed Extract to help try to boost my immune system. Still, I have a sinking feeling that the Augmentin isn't working even though it's supposed to. He did do another culture & sensitivity test yesterday, to confirm, so I will hopefully know those results soon.

 

I'm not looking for medical advice, just support I guess. Advice on how to wean as "gently" as possible, although it may have to be abrupt. I really, do not want to wean my baby anytime soon, but I also don't want to risk this infection turning into osteomyelitis or costing me my toe. I'm also worried about this affecting my school commitments - I really can't spend more than a day or two in the hospital.  I am in my mid-20s, don't have diabetes (to my knowledge) and have good circulation, so we're all a bit baffled why my wound is not healing. It is actually becoming more painful...

 

Thanks for reading my novel.

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Old 09-27-2012, 07:16 PM
 
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hug.gif and support to you. I hope your infection is cleared up soon. I recall some other threads about weaning suddenly due to medical issues; if I can find them, I'll add some links to this post.
 


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Old 09-27-2012, 07:48 PM
 
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I know you didn't ask for medical advice but have you looked up the proposed ABs in Hales? Vancomycin is an L1. Only a small amount is excreted in breastmillk and it has pretty poor GI absorption so the baby gets very little systemically. Linezolid is an L3, primarily due to lack of research on humans.
I think if you had intended to continue breastfeeding for any length of time beyond this point the benefits of ongoing breastfeeding would outweigh the possible risks of using vanc.

For what it's worth I have been a midwife and ED nurse for 10+ years and I would take the vanc and keep breastfeeding.

Sorry if this is not what you wanted from this thread but I thought it was worth throwing it out there.

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