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Is Susan trying to harm my baby? Should I request to see Jan instead? **long**

Posted by on Feb. 18, 2013 at 11:45 AM
  • 22 Replies

The Ob/GYN office I go to has 2 women who work there: Jan who is a N.P., C.N.M. which stands for nurse practitioner and certified nurse midwife and then there's

Susan who is C.N.M.

Back in October of 2012 I was having milk supply issues and I wanted to increase it.

I spoke with Susan about it and she prescribed me metoclopramide. I didn't even bother to ask her if this would harm my baby because I was EBFing. She obviously knew I was breastfeeding so I figured she wouldn't prescribe me something that would have THIS much effect on my baby and me. 

I took them for two days and not only did it make me extremely exhausted but it also made my, at the time, 3 month old extremely exhausted and his behavior changed alot; going from being happy and full of energy to very exhausted and cranky all of the time.

So I stopped taking that medicine after 2 days of using it.

Fast forward to last Thursday, which is when I had my annual exam with Susan. 

On Friday I received a phone call from my OB's office and I spoke with a nurse named Danielle she said that I have bacterial vaginosis. But she was working along side with Susan (who is C.N.M)

Danielle was explaining to me how it's a common disease for women to have. And she gave me an option of either taking a pill or a gel.

I decided to take a pill. She prescribed me a pill called Flagyl but the generic for it is Metronidazole. I asked Danielle if it's safe to take because I'm breastfeeding. She put me on hold so she could ask Susan. Danielle told me that Susan said it's completely safe to take while breastfeeding.

So I went to pick up my prescription at my pharmacy and I second guessed Susan (because of the drug she gave me before) and decided to ask the pharmacist if this drug was ok to take while breastfeeding.

Well.....she told me differently. She said no and she also gave me 3 sheets to explain why it's not ok to take.

It says in the paperwork that "metronidazole is excreted into break milk. Breastfeeding is not recommended by the manufacturer during treatment."

I'm suppose to take this for 7 consecutive days. I'm very concerned and I'm wondering if I should just request seeing Jan from now on instead of Susan. What do you think?

It says, "The American Academy of Pediatrics (AAP) has stated that if a single 2g oral dose is given for trichomoniasis, then nursing may be resumed in 12-24 hours. Otherwise, if other dosage regimens are used, nursing may be resumed within 24-48 hours after the last dose of treatment is completed. In a study of 3 patients that received a single 2g oral dose, peak milk concentrations ranged between 50-60 mcg/ml at 2-4 hours after the dose. If breastfeeding were to continue, the estimated infant exposure during the next 48 hours would be 25.3 mg; if breastfeeding was interrupted for 12 hours, the estimated 48 hour exposure would be 9.8mg and if breastfeeding was interrupted for 24 hours the estimated 48 hour exposure would be 3.5 mg."

Lilypie Breastfeeding tickers

by on Feb. 18, 2013 at 11:45 AM
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Starshine-bela
by Leah on Feb. 18, 2013 at 11:52 AM
That's crazy, I wouldn't see susan anymore. If there is someone to report her to, I would. What if you hadn't second guessed her? What if the next time with another mom she isn't second guessed? She obviously doesn't know what she is doing.
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vinalex0581
by on Feb. 18, 2013 at 11:56 AM

BUMP!

mamabens
by Miranda on Feb. 18, 2013 at 12:21 PM
1 mom liked this

First never take medicine advice regarding bfing from a pharmacist, most meds are fine and the med insert is a cya thing. Any doubt on meds should be looked up on lactmed or call infant risk hotline. As for the other, if you're more comfy with the other then see her instead

 BabyFruit Ticker


vinalex0581
by on Feb. 18, 2013 at 12:51 PM

is it lactmed.com?

how reliable is it?

Quoting mamabens:

First never take medicine advice regarding bfing from a pharmacist, most meds are fine and the med insert is a cya thing. Any doubt on meds should be looked up on lactmed or call infant risk hotline. As for the other, if you're more comfy with the other then see her instead


Lilypie Breastfeeding tickers

mollysmom328
by Stephanie on Feb. 18, 2013 at 1:09 PM


I decided to take a pill. She prescribed me a pill called Flagyl but the generic for it is Metronidazole. I asked Danielle if it's safe to take because I'm breastfeeding. She put me on hold so she could ask Susan. Danielle told me that Susan said it's completely safe to take while breastfeeding.


I like using the Infant Risk forum to search for posts.  This is a response from Infant Risk

Dear Shelmom,
It is probably same for you to continue breastfeeding while taking Flagyl. Flagyl is a drug that is used in young babies including premature babies at much higher doses than what is transferred through breastmilk. We know that it does transfer into milk quite a bit, however, it has not been linked with any major adverse effects in the baby. Monitor the baby for diarrhea. I hope this is helpful.
Maria Milla, MD
InfantRisk Center

So I went to pick up my prescription at my pharmacy and I second guessed Susan (because of the drug she gave me before) and decided to ask the pharmacist if this drug was ok to take while breastfeeding.

The pharmacist gave you the drug company info.  Don't trust the pharmacist.

I'm suppose to take this for 7 consecutive days. I'm very concerned and I'm wondering if I should just request seeing Jan from now on instead of Susan. What do you think?

Dosage?  The below info you pulled is a different drug than you listed is it the same drug?  This is another expert from the Hale (infant risk) forum


With metronidazole, if you use the standard 500 mg BID, or 250 mg TID, then it is probably quite safe to breastfeed. If you use the 2 gram STAT dose, then the infant should be withdrawn from the breast for at least 12-24 hours, and the milk pumped and discarded. The dose in milk following a 2 gram dose could be exceedingly high, thus take the infant off the breast. With tinidazole, most of the dosing recommendations are 1-2 grams STAT. At this dose, I would recommend you interrupt breastfeeding for about 24 hours, as it has a slightly longer elimination half-life than metronidazole.

It says, "The American Academy of Pediatrics (AAP) has stated that if a single 2g oral dose is given for trichomoniasis, then nursing may be resumed in 12-24 hours. Otherwise, if other dosage regimens are used, nursing may be resumed within 24-48 hours after the last dose of treatment is completed. In a study of 3 patients that received a single 2g oral dose, peak milk concentrations ranged between 50-60 mcg/ml at 2-4 hours after the dose. If breastfeeding were to continue, the estimated infant exposure during the next 48 hours would be 25.3 mg; if breastfeeding was interrupted for 12 hours, the estimated 48 hour exposure would be 9.8mg and if breastfeeding was interrupted for 24 hours the estimated 48 hour exposure would be 3.5 mg."



audmom1218
by Silver Member on Feb. 18, 2013 at 1:22 PM
I wouldn't trust a doctor who prescribes metoclopramide without first warning you that it can cause sudden anxiety, depression, and migraines! My ob prescribed that for morning sickness and the side effects were 1000x worse than the nauseau! I'm talking debilitating anxiety and uncontrollable crying in a person with no history of anxiety, after only 3 days!

As for lactmed it is THE SOURCE for accurate bf info. From others responses I am gathering that yea it gets into the milk but the dosage is safe for an infant to take.


Quoting vinalex0581:

The Ob/GYN office I go to has 2 women who work there: Jan who is a N.P., C.N.M. which stands for nurse practitioner and certified nurse midwife and then there's

Susan who is C.N.M.

Back in October of 2012 I was having milk supply issues and I wanted to increase it.

I spoke with Susan about it and she prescribed me metoclopramide. I didn't even bother to ask her if this would harm my baby because I was EBFing. She obviously knew I was breastfeeding so I figured she wouldn't prescribe me something that would have THIS much effect on my baby and me. 

I took them for two days and not only did it make me extremely exhausted but it also made my, at the time, 3 month old extremely exhausted and his behavior changed alot; going from being happy and full of energy to very exhausted and cranky all of the time.

So I stopped taking that medicine after 2 days of using it.

Fast forward to last Thursday, which is when I had my annual exam with Susan. 

On Friday I received a phone call from my OB's office and I spoke with a nurse named Danielle she said that I have bacterial vaginosis. But she was working along side with Susan (who is C.N.M)

Danielle was explaining to me how it's a common disease for women to have. And she gave me an option of either taking a pill or a gel.

I decided to take a pill. She prescribed me a pill called Flagyl but the generic for it is Metronidazole. I asked Danielle if it's safe to take because I'm breastfeeding. She put me on hold so she could ask Susan. Danielle told me that Susan said it's completely safe to take while breastfeeding.

So I went to pick up my prescription at my pharmacy and I second guessed Susan (because of the drug she gave me before) and decided to ask the pharmacist if this drug was ok to take while breastfeeding.

Well.....she told me differently. She said no and she also gave me 3 sheets to explain why it's not ok to take.

It says in the paperwork that "metronidazole is excreted into break milk. Breastfeeding is not recommended by the manufacturer during treatment."

I'm suppose to take this for 7 consecutive days. I'm very concerned and I'm wondering if I should just request seeing Jan from now on instead of Susan. What do you think?

It says, "The American Academy of Pediatrics (AAP) has stated that if a single 2g oral dose is given for trichomoniasis, then nursing may be resumed in 12-24 hours. Otherwise, if other dosage regimens are used, nursing may be resumed within 24-48 hours after the last dose of treatment is completed. In a study of 3 patients that received a single 2g oral dose, peak milk concentrations ranged between 50-60 mcg/ml at 2-4 hours after the dose. If breastfeeding were to continue, the estimated infant exposure during the next 48 hours would be 25.3 mg; if breastfeeding was interrupted for 12 hours, the estimated 48 hour exposure would be 9.8mg and if breastfeeding was interrupted for 24 hours the estimated 48 hour exposure would be 3.5 mg."


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K8wizzo
by Kate on Feb. 18, 2013 at 1:28 PM

Flagyl is fine, take it as prescribed.

As for who you see.... I'd be wary of seeing someone who didn't tell you the possible side effects of metoclopramide AND who prescribed it when you didn't actually have a supply problem.  Stick with the other one from now on.

MommyO2-6631
by Leslie on Feb. 18, 2013 at 1:48 PM
In my experience flagyl does not work. It just causes a yeast infection and the bv is still there after a round of monistat
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IrishIz
by Silver Member on Feb. 18, 2013 at 2:03 PM
3 moms liked this

Flagyl is safe and that pharmacist knows NOTHING about breastfeeding.  The pharmacist only has the ability to READ the pamphlet and that pamphlet isn't really the answer to whether you can breastfeed with that med.  Flaygyl is an L2 and the dosage used for BV is perfectly safe.

Meoclopramide is Reglan.  Reglan is an L2 and again is safe for breastfeeding.  The problem with Reglan is that it can have very serious side effects.  You should have been told that Reglan has a black box warning and that while safe for breastfeeding has some issues that you can be aware of.  

So Susan the CNM gave you safe medications.  She should have done some education for the Reglan before giving it to you.

Erin, IBCLC

tabi_cat1023
by Group Mod - Tabitha on Feb. 18, 2013 at 2:09 PM
Yep shes right.

Since you are having such side effects from reglan maybe we can troubleshoot the supply issues and can find the cause and thus a different solution.


Quoting IrishIz:

Flagyl is safe and that pharmacist knows NOTHING about breastfeeding.  The pharmacist only has the ability to READ the pamphlet and that pamphlet isn't really the answer to whether you can breastfeed with that med.  Flaygyl is an L2 and the dosage used for BV is perfectly safe.

Meoclopramide is Reglan.  Reglan is an L2 and again is safe for breastfeeding.  The problem with Reglan is that it can have very serious side effects.  You should have been told that Reglan has a black box warning and that while safe for breastfeeding has some issues that you can be aware of.  

So Susan the CNM gave you safe medications.  She should have done some education for the Reglan before giving it to you.

Erin, IBCLC


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