July 16, 2010,
B.W. asks from Bethel Park, PA on July 15, 2010
I am breastfeeding my 5 1/2 week old. I went to the doctor for a throat culture to see if i have strep. She did not do the rapid test only the culture and said i won't find out until monday. She thinks it is strep so she put me on erythromycin so if i do have it, i won't spread it to the baby. Stupid me read online about erythromycin. while the American Academy of Pediatrics says it is safe, I read reports where in early postnatal it can cause some problem in newborns that is only treated with surgery. I am allergic to penicillin so i can't take that. Has anybody had any experience taking it with a little baby? or any nurses or anything at all?
So What Happened?™
Well i hadn't taken it, and my son had a fever of 100.2 this morning so i took him to the doctor. The pediatrician looked at my throat and said i had hand/foot/mouth that it's been going around. His throat was a little red too. She says the strep test will probably be negative. And antibiotics don't work for this, so i'm not going to take the erythromycin until i hear back from my doctor. I called them this morning before I went to the pediatrician to find out if i could do a quick strep test so that i could know if my son might have that. They couldn't get me in to my doctor, how horrible is that?, but she said i should get the results today.
K.H. answers from Philadelphia on July 16, 2010
M.M. answers from Chicago on July 15, 2010
K.C. answers from Barnstable on July 15, 2010
The best, most respected source of medications and breastfeeding is found on the Thomas Hale site. He publishes Medications and Mother's Milk, but here is a link into his medications forum (you can' post a question, but you can read what he writes to doctors):
I have his 2008 book. Here is the info on erythromycin:
-- listed as an L2 (safe)
-- has a peak plasma level 2 to 4 hours after taking it (meaning it is at it's most concentrated in your blood at that time)
-- has a very short half life of 1.5 to 2 hours (meaning your body processes it out of your system fast - this is good.
-- has a relative Infant does of 1.7% of what you take BUT
-- Also has a high Protein binding capacity of 84% (high protein binding capacities have a hard time passing into milk.
HOWEVER . . . Hale warns that use of this drug in breastfeeding mothers with VERY YOUNG NEWBORNS runs the risk of the child developing infantile hypertrophic stenosis (though the study was from 2003).
If you really need to be on it, try to nurse around the peak plasma level. Once your child hits 7 to 8 weeks, I would take this medication without worry.
A.P. answers from Allentown on July 16, 2010
In my 2006 Dr. Hale's "Medications & Mother's Milk" book (the Bible of medications and pregancy/breastfeeding) it is listed as an L1, which is the safest possible level. It's the same risk category as Tylenol or a multi-vitamin! Perfectly safe to take!
There have been NO pediatric concerns reported via breastmilk; there is a small risk of diarrhea (and breastmilk is the perfect cure/treatment for that!). The book suggests that the bioavailability is very poor (ie: the infant gets very, very, very little of what you're ingesting of this medication).
Keep on nursing & I hope you feel better soon!!!
D.S. answers from Allentown on July 15, 2010
Talk to your pharmacist. Good luck.
Are you allergic to Penicillin?
Good luck. Thanks for caring about your baby.
D.C. answers from Pittsburgh on July 16, 2010
Hales is the most respected site for drugs and breastfeeding. A second one is safefetus.com which has info during pregnancy and breastfeeding. Like Hales, it has it listed as 'compatible with breastfeeding'.
That said, if you want to minimize the amount your baby gets, feed your baby immediately before or immediately after taking a dose. Then hopefully she won't need to eat again for at least 3 hours, so she won't eat when the drug concentration is highest in your body and thus she'll get a lower dose. I know newborns are unpredictable with eating patterns, so it might not work great, but it's the best you can do.