BV, breastfeeding and Clindamycin (Clindamax)

[freak4music.livejournal.com]

I am a nursing mother to a 8 week old daughter. I plan on extended nursing as I did with my son. I recently went in for my 6 week postpartum appointment and had a culture and pap done as well. Late last week a nurse for the Nurse Practitioner in the office (who I have never seen) called to tell me that my culture came back showing I had a bacterial infection and since my midwife was out of the office they wanted to get this taken care of for me and wanted to know which pharmacy to call in a prescription for Flagyl for me. I had previously taken Flagyl (before either of my children) and had a problem keeping it down, it severely upset my stomach. I explained this to the nurse and also asked her if I could even take Flagyl while breastfeeding. She stated she didnt know if it would be okay and that she didnt even know I was postpartum. Wow, the NP was willing to write a prescription for me without even consulting my chart? I had been in less than a week early and watch my midwifes nurse chart that I exclusively breastfeed. The nurse called back and said no I couldnt take Flagyl while breastfeeding unless I pumped and dumped so the NP had already called in a prescription for Clindamycin HCL cream to my pharmacy and that I could take that while BF with no problems. I picked up the precripstion yesterday and looked at the insert which said "Clindamycin has been detected in human milk after oral or parenteral administration. It is not known if clindamycin is excreted in human milk folllowing the use of vaginally administered clindamycin phosphate. Because of the potential for serious adverse reactions in nursing infants from clindamycin phosphate, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother". I read that as "dont take while nursing". I called the pharmacist and she said "That wording is on every single drug so that the drug companies can cover themselves legally. I believe it is safe for you to take this and nurse". I still feel uneasy.

Has anyone here taken Clindamycin while nursing? Is it safe for me to do this? I plan on calling my midwife on Monday because I am supposed to go in Friday to have an IUD put in and I want her opinion on this and to see if there is something else I may be able to take. I feel uncomfortable taking something that in my opinion says not to take if you are nursing. Am I wrong? Is this safe?

X-Posted to a few parenting communities and BF as well......

Comments

[geminigirl]

I'm sure by this point someone with Hale's will have checked it. I don't have a copy (I usually just call my LC when I'm unsure about the safety of a prescription while nursing) but I did search on Amazon inside and Hale's has it as an L2...considered safe for nursing. That said, I was given Clindamycin while in labor, via IV for prolonged rupture of membranes, (my labor started with water breaking and my daughter wasn't actually born for another 34.5 hours) and chances are the concentration the baby got via IV is higher than what would be passed via breastmilk. It's also a medication used in infants to treat infection, which would lean towards it also being okay to use while breastfeeding.

However, if the NP's behavior is as you described, if I were in your shoes and had an asymptomatic infection, I'd be reluctant to take any medication she prescribed without consulting your actual practitioner.

Congratulations on the new baby though.

[freak4music.livejournal.com]

Thank you! Mom of two kids...when did this all happen??
I am going to give my midwife a call tomorrow....

[storychick.livejournal.com]

I think your NP is less aware of medication while breastfeeding than she ought to be. Flagyl is safe for nursing, according to Thomas Hale (the author of Medications and Mother's Milk, the absolute source for this) -- enter as a guest and then do a search on flagyl here: http://neonatal.ama.ttuhsc.edu/lact/medicationforumspage.html

Clindamycin is safe, as well, but is a much more powerful medication generally used for MRSA. I would rather take the Flayl, myself, to avoid overuse of the high-powered drugs, but of course its your body. :) I would consult with a pharmacist that has a copy of Hale's book since your NP is underinformed. I'd hope your MW is more of a resource also.

Almost all drugs have warnings, by the way, because they manufacturers can't or won't do studies on breastfeeding mothers/newborns and so they are covering their liability butts.