Medicine while breastfeeding

You can take certain antiobiotics safely while pregnant or nursing to treat pouchitis. Augmentin is one that works well and is safe to take.

Just recently contacted my doc about this because pouchitis is definitely back Dr. said that all antibiotics (including augmentin) are excreted in breast milk, so it's the old risk vs. benefit thing... I'm not going to stop breastfeeding so do I risk the exposure to antibiotics in my baby?

She also said I could try budesinide again but it's the same dilemma.

How about topical treatments? You can use budesonide enemas for pouchitis with less systemic effect.

Jan

I'll ask about that. I didn't even know it was an option. I feel more hesitant about the antibiotics since we all know here the importance of maintaining healthy gut flora. For such a little baby I think the antibiotics could potentially be more dangerous than the steriods - I could be wrong; but that's my "gut" feeling

Also, my doctor suggested I could pump and discard my milk after taking the budesinide based on a study of prednisone that showed the highest concentration of the medicine showed up in breast milk in the first 4 hours.

I was on Flagyl while breastfeeding and I was told to pump and dump by my GI. It was so hard on both of us! In the end, I couldn't stand it and decided to breastfeed while on Flagyl (the 250mg dose), but not within two hours of taking the medication. Or I would pump and dump some feeds, but nurse her to sleep. Again, this was my decision, just so you know someone out there risked it.

I was also on Flagyl while pregnant (2nd and 3rd trimesters). Next pregnancy (and breastfeeding) I was on Remicade. It's such a hard decision to make, but I weighed the advice of my GI, OB, pediatrician and the lactation nurses at my hospital (who were willing to look up the milk studies for me).

Laura

I was told there was very little risk of issues while taking Augmentin (category B drug). I was on it for 15 months (9 months of pregnancy plus 6 months of nursing). My son never had any negative side effects.

Thanks for the replies. I was tapering off budesinide when my baby was born and my GI also recommended I pump and dump - at that point there was no way with a newborn, the work we had to put into establishing breastfeeding, plus the physical and emotional exhaustion. Now we're in a good enough pattern I think we could make it work although it would be a pain.

I'm going to check on the enema option and discuss everything with my pediatrician then make a decision.

i'll just add one more thing about amoxicillin as you are trying to make your decision. although small amounts are excreted into your milk, the adverse side effects that could happen aren't scary side effects. you'd be able to clearly see them in your baby and then you could stop taking the medicine or start to pump and dump at that time. this was the advice of my pediatrian and GI...to watch and see. the benefits of a mother's milk far outweighed the small risk of side effects from the antibiotic. the concerns to watch for are that the baby could get thrush or diarrhea from upset of flora (same side effects that we could get). and since you look in the baby's mouth and at their butt all day long, you'd know if it was bothering them pretty quickly.

Historically I used both rowassa enemas and cortenemas to treat pouchitis. I thought Budesonide doesn't release until it gets to the large intestine, so was not supposed to be (as) systemic so thought perhaps that would be safer regarding breatmilk? Also, xifaxin is an antibiotic that is supposedly not systemic, either, so those might be possibilities to ask about? Maybe a pharmacist would know best?

Google Dr. Thomas Hale. He publishes and researches on medication and breastmilk. Many, many medicines are perfectly fine to use while breastfeeding but doctors typically just tell people to pump and dump when they don't need to. And note that the pregnancy risk ratings are different from lactation risk ratings.

This is a thread on Flagyl: http://www.infantrisk.com/foru...index.php/t-271.html

Note that he doesn't answer questions from moms but does from lactation consultants and La Leche League leaders. Your local La Leche League leader should have a copy of his book to be able to look up medications. Good luck!

Oh Breezie, you are right about the category. I stated the pregnancy category for amoxicillin. The lactation rating is L1 which is the most compatible.

Hey again. Thanks everyone for your helpful input. Here are my findings/conclusions:
[LIST]

Entocort is not available in an enema, and per my doctor, other steroid enemas are not very effective at treating pouchitis.

I didn't *notice* any negative side effects of the entocort when I was taking it, except that I had to delay baby's shots. She just caught up on her newborn/2 month shots so I don't want to have to delay her 6 and 9 month shots if possible.

Pediatrician said he was ok with two weeks of amoxycillan, HOWEVER

Reading this stuff - http://www.thealphaparent.com/...ote-for-parents.html http://www.thealphaparent.com/...ote-for-parents.html and http://www.ncbi.nlm.nih.gov/pubmed/9890463 made me feel very cautious about using antibiotics, at least until baby is about 6 months old.

So, as long as the pouchitis is moderate, I'm going to hold off any meds - at least until baby is 6 months old, which will be end of November.

Which means I need to be REALLY good on my diet the next two months...

I breastfed my baby for 20 months - the entire time on Augmentin from day one until a month ago when I had to stop as I had my jpouch removed. Doctors said I had to take drugs and also that it was unlikely to cause any problems - he's been fine - fabulous actually! I also took it and keflex through the entire pregnancy. Good luck with your decision.

In my early years with my pouch, if Flagyl didn't work on my pouchitis, cortenemas did the trick every time!

But sounds like you have done good research-hope you can stay healthy enough to finish breastfeeding without issue!