Quick - Anyone Know about Breastfeeding and IV Tobi?

K

Kristen

New member
My doctor wants to start me on a 10-day course of IV Tobramycin tomorrow, and he told me that I can't nurse while I'm on it. But, when I looked up info about this, all I found was that it's a pregnancy category D med, but that it's safe for nursing because, whatever makes it into my milk won't be absorbed by her because Tobramycin isn't absorbed when taken orally. So, now I'm wondering if he said "no" solely based on the pregnancy category. Has anyone else faced this issue?

DD won't take a bottle, so this is going to be a big challenge. (She's almost 10-1/2 months). Also, I am hoping I can pump and dump while I'm on it and then continue nursing after. But, I haven't been responding to the pump very well, so I'm afraid this means we are going to have to wean <img src="i/expressions/face-icon-small-sad.gif" border="0"> I want to do what is best for her, so, if there is a risk, I am fine not nursing, but I just want to make sure I have all the info and we aren't going to go through all this trouble when I could just continue to nurse her.
 
K

Kristen

New member
My doctor wants to start me on a 10-day course of IV Tobramycin tomorrow, and he told me that I can't nurse while I'm on it. But, when I looked up info about this, all I found was that it's a pregnancy category D med, but that it's safe for nursing because, whatever makes it into my milk won't be absorbed by her because Tobramycin isn't absorbed when taken orally. So, now I'm wondering if he said "no" solely based on the pregnancy category. Has anyone else faced this issue?

DD won't take a bottle, so this is going to be a big challenge. (She's almost 10-1/2 months). Also, I am hoping I can pump and dump while I'm on it and then continue nursing after. But, I haven't been responding to the pump very well, so I'm afraid this means we are going to have to wean <img src="i/expressions/face-icon-small-sad.gif" border="0"> I want to do what is best for her, so, if there is a risk, I am fine not nursing, but I just want to make sure I have all the info and we aren't going to go through all this trouble when I could just continue to nurse her.
 
K

Kristen

New member
My doctor wants to start me on a 10-day course of IV Tobramycin tomorrow, and he told me that I can't nurse while I'm on it. But, when I looked up info about this, all I found was that it's a pregnancy category D med, but that it's safe for nursing because, whatever makes it into my milk won't be absorbed by her because Tobramycin isn't absorbed when taken orally. So, now I'm wondering if he said "no" solely based on the pregnancy category. Has anyone else faced this issue?
<br />
<br />DD won't take a bottle, so this is going to be a big challenge. (She's almost 10-1/2 months). Also, I am hoping I can pump and dump while I'm on it and then continue nursing after. But, I haven't been responding to the pump very well, so I'm afraid this means we are going to have to wean <img src="i/expressions/face-icon-small-sad.gif" border="0"> I want to do what is best for her, so, if there is a risk, I am fine not nursing, but I just want to make sure I have all the info and we aren't going to go through all this trouble when I could just continue to nurse her.
 
L

LouLou

New member
Might want to pick up a copy of Hale's book Medication and Mother's Milk.
Here's his forum you can search but not post.
This thread is on topic.
<a target=_blank class=ftalternatingbarlinklarge href="http://neonatal.ttuhsc.edu/discus/messages/40/85857.html?1222704096">http://neonatal.ttuhsc.edu/dis.../85857.html?1222704096</a>
 
L

LouLou

New member
Might want to pick up a copy of Hale's book Medication and Mother's Milk.
Here's his forum you can search but not post.
This thread is on topic.
<a target=_blank class=ftalternatingbarlinklarge href="http://neonatal.ttuhsc.edu/discus/messages/40/85857.html?1222704096">http://neonatal.ttuhsc.edu/dis.../85857.html?1222704096</a>
 
L

LouLou

New member
Might want to pick up a copy of Hale's book Medication and Mother's Milk.
<br />Here's his forum you can search but not post.
<br />This thread is on topic.
<br /><a target=_blank class=ftalternatingbarlinklarge href="http://neonatal.ttuhsc.edu/discus/messages/40/85857.html?1222704096">http://neonatal.ttuhsc.edu/dis.../85857.html?1222704096</a>
 
M

mamaScarlett

Active member
Oh yes, I went through the TOBI breastfeeding saga too. Basically, my doctor and I opted to err on the side of caution through my pregnancy regarding the use of TOBI. Alot of docs sit on the fence regarding TOBI use during pregnancy and breastfeeding.
When DD was 7 months, I needed TOBI but wasn't ready to stop BF. I got a lactation consultant to help me. You can not trust what is said about the pregnancy category of a drug when it comes to BF-the ratings are totally different for each. I ditto the Hale book-get it. It was a lifesaver for me.
My Cf doc did not consider TOBI to be safe for BF. But, the lactation nurses did (i got several opinions). However, I did decide to be overly cautious, and split BF and supplementing with formula. Plus, DD was eating some foods by then so that helped. Basically, I BF her first thing in the AM, then did tobi. Then pumped and dumped an hr later. (to keep my milk supply going) Then BF 2ish more times in the day, then did tobi before bed, and pumped and dumped again. Between BF, I gave her a bottle of formula.
Pediatrician, Cf docs, lactation consultants all felt this was a happy medium for everyone. Maybe it was overkill but it was what got me through it at the time. I would not be too worried about TOBI and BF.
Bottom line, I think its more important to BF your LO as long as possible and take the teeny tiny % of a risk (which is probably none). Remember that formula even has a LC rating, as does the air that we breathe, and coffee!

Wanted to add, I apologize bc of the title of the thread I thought you were talking about TOBI inhaled, and I just realized its iv tobra. So I didn't take that while BF, but there's my story anyhow. I did do IVs while I BF however, just not Tobra. Perhaps there's another IV med option for you?
 
M

mamaScarlett

Active member
Oh yes, I went through the TOBI breastfeeding saga too. Basically, my doctor and I opted to err on the side of caution through my pregnancy regarding the use of TOBI. Alot of docs sit on the fence regarding TOBI use during pregnancy and breastfeeding.
When DD was 7 months, I needed TOBI but wasn't ready to stop BF. I got a lactation consultant to help me. You can not trust what is said about the pregnancy category of a drug when it comes to BF-the ratings are totally different for each. I ditto the Hale book-get it. It was a lifesaver for me.
My Cf doc did not consider TOBI to be safe for BF. But, the lactation nurses did (i got several opinions). However, I did decide to be overly cautious, and split BF and supplementing with formula. Plus, DD was eating some foods by then so that helped. Basically, I BF her first thing in the AM, then did tobi. Then pumped and dumped an hr later. (to keep my milk supply going) Then BF 2ish more times in the day, then did tobi before bed, and pumped and dumped again. Between BF, I gave her a bottle of formula.
Pediatrician, Cf docs, lactation consultants all felt this was a happy medium for everyone. Maybe it was overkill but it was what got me through it at the time. I would not be too worried about TOBI and BF.
Bottom line, I think its more important to BF your LO as long as possible and take the teeny tiny % of a risk (which is probably none). Remember that formula even has a LC rating, as does the air that we breathe, and coffee!

Wanted to add, I apologize bc of the title of the thread I thought you were talking about TOBI inhaled, and I just realized its iv tobra. So I didn't take that while BF, but there's my story anyhow. I did do IVs while I BF however, just not Tobra. Perhaps there's another IV med option for you?
 
M

mamaScarlett

Active member
Oh yes, I went through the TOBI breastfeeding saga too. Basically, my doctor and I opted to err on the side of caution through my pregnancy regarding the use of TOBI. Alot of docs sit on the fence regarding TOBI use during pregnancy and breastfeeding.
<br />When DD was 7 months, I needed TOBI but wasn't ready to stop BF. I got a lactation consultant to help me. You can not trust what is said about the pregnancy category of a drug when it comes to BF-the ratings are totally different for each. I ditto the Hale book-get it. It was a lifesaver for me.
<br />My Cf doc did not consider TOBI to be safe for BF. But, the lactation nurses did (i got several opinions). However, I did decide to be overly cautious, and split BF and supplementing with formula. Plus, DD was eating some foods by then so that helped. Basically, I BF her first thing in the AM, then did tobi. Then pumped and dumped an hr later. (to keep my milk supply going) Then BF 2ish more times in the day, then did tobi before bed, and pumped and dumped again. Between BF, I gave her a bottle of formula.
<br />Pediatrician, Cf docs, lactation consultants all felt this was a happy medium for everyone. Maybe it was overkill but it was what got me through it at the time. I would not be too worried about TOBI and BF.
<br />Bottom line, I think its more important to BF your LO as long as possible and take the teeny tiny % of a risk (which is probably none). Remember that formula even has a LC rating, as does the air that we breathe, and coffee!
<br />
<br />Wanted to add, I apologize bc of the title of the thread I thought you were talking about TOBI inhaled, and I just realized its iv tobra. So I didn't take that while BF, but there's my story anyhow. I did do IVs while I BF however, just not Tobra. Perhaps there's another IV med option for you?
 
M

Melissa75

Administrator
Your dr and Hale's are great resources. I can only add that if you deny Lillian the breast, you'll likely respond very well to the pump.

I stopped nursing for meds with my last kid. He was 11 months and eating lots of solids. I thought he wasn't taking all that much milk from me and I wouldn't get engorged. HA HA...and yee-ouch. I was ready to wean, so it was a delicate balance to pump enough to relieve the pressure and not pump so much I kept up my supply when I was trying to dry out. I ended up with a couple "walnuts" on my chest for about six weeks: plugged but not infected milk ducts (likely not infected because of all the antibiotics I was on for my lungs!).

The only other thing I will add is that I feel most pediatricians have an unfounded belief that babies need to give up bottles by the time they are one. I say unfounded because children worldwide nurse until as late as four. And what is better about a straw or a hard sippy spout? Babies still find a lot of comfort from the act of sucking on bottle & breast nipples, pacifiers and thumbs, well past the age of one. So, my advice is that if you do wean, don't feel pressured to ditch the bottle just as soon as Lillian learns to take it and find comfort in it.

(All my kids refused bottles while nursing (12, 15 & 11 mos), and all of them transitioned to bottles when they weaned. My only rule was no sleeping with the bottle. None have any issues from my ignoring the pediatricians recommendation to stop using bottles at one.)
 
M

Melissa75

Administrator
Your dr and Hale's are great resources. I can only add that if you deny Lillian the breast, you'll likely respond very well to the pump.

I stopped nursing for meds with my last kid. He was 11 months and eating lots of solids. I thought he wasn't taking all that much milk from me and I wouldn't get engorged. HA HA...and yee-ouch. I was ready to wean, so it was a delicate balance to pump enough to relieve the pressure and not pump so much I kept up my supply when I was trying to dry out. I ended up with a couple "walnuts" on my chest for about six weeks: plugged but not infected milk ducts (likely not infected because of all the antibiotics I was on for my lungs!).

The only other thing I will add is that I feel most pediatricians have an unfounded belief that babies need to give up bottles by the time they are one. I say unfounded because children worldwide nurse until as late as four. And what is better about a straw or a hard sippy spout? Babies still find a lot of comfort from the act of sucking on bottle & breast nipples, pacifiers and thumbs, well past the age of one. So, my advice is that if you do wean, don't feel pressured to ditch the bottle just as soon as Lillian learns to take it and find comfort in it.

(All my kids refused bottles while nursing (12, 15 & 11 mos), and all of them transitioned to bottles when they weaned. My only rule was no sleeping with the bottle. None have any issues from my ignoring the pediatricians recommendation to stop using bottles at one.)
 
M

Melissa75

Administrator
Your dr and Hale's are great resources. I can only add that if you deny Lillian the breast, you'll likely respond very well to the pump.
<br />
<br />I stopped nursing for meds with my last kid. He was 11 months and eating lots of solids. I thought he wasn't taking all that much milk from me and I wouldn't get engorged. HA HA...and yee-ouch. I was ready to wean, so it was a delicate balance to pump enough to relieve the pressure and not pump so much I kept up my supply when I was trying to dry out. I ended up with a couple "walnuts" on my chest for about six weeks: plugged but not infected milk ducts (likely not infected because of all the antibiotics I was on for my lungs!).
<br />
<br />The only other thing I will add is that I feel most pediatricians have an unfounded belief that babies need to give up bottles by the time they are one. I say unfounded because children worldwide nurse until as late as four. And what is better about a straw or a hard sippy spout? Babies still find a lot of comfort from the act of sucking on bottle & breast nipples, pacifiers and thumbs, well past the age of one. So, my advice is that if you do wean, don't feel pressured to ditch the bottle just as soon as Lillian learns to take it and find comfort in it.
<br />
<br />(All my kids refused bottles while nursing (12, 15 & 11 mos), and all of them transitioned to bottles when they weaned. My only rule was no sleeping with the bottle. None have any issues from my ignoring the pediatricians recommendation to stop using bottles at one.)
 
K

Keepercjr

Guest
No!! You don't need to wean her and you don't need to stop nursing. She won't absorb any of that tobra. I understand that docs want to err on the side of caution but when they know nothing about what they are talking about it really irritates me! They just do not understand the importance of a nursing relationship. It isn't so easy just to say to your BABY "sorry you can't nurse anymore even though just last night you nursed and you won't understand but oh well doctor says so". And it is not easy on the mother easy. Emotionally or physically. You would have to deal with your IV meds, pumping, dealing with an ANGRY SAD CRYING baby who won't take a bottle and your own emotions on the matter.

If I were in your shoes (and I have been there just not IV meds - oral and inhaled) I would nurse her. Give her some baby probiotics (and most definitely take some yourself) and just nurse her like usual. I'm sorry but there is no way I'm relying on my CF doc for ANY breastfeeding advice. Dr. Hale is #1 authority in my book and if I had additional questions I would ask a lactation consultant. Most hospitals have them and you can just call and ask to speak to one.

My daughter is now 2.5 and I have no plans to stop nursing her till she is ready, whenever that may be. She was VERY ill a few weeks ago and I honestly believe that nursing was the only thing that kept her out of the hospital. She had a horrible stomach bug on top of a cold. She threw up for over a week. But I was able to keep her hydrated just enough and knew that she was getting at least some nutrition and electrolytes from nursing. She lost 2-3 lbs which when you are only 25 lbs to begin with is a lot!

Let us know how everything is when you get a chance.
 
K

Keepercjr

Guest
No!! You don't need to wean her and you don't need to stop nursing. She won't absorb any of that tobra. I understand that docs want to err on the side of caution but when they know nothing about what they are talking about it really irritates me! They just do not understand the importance of a nursing relationship. It isn't so easy just to say to your BABY "sorry you can't nurse anymore even though just last night you nursed and you won't understand but oh well doctor says so". And it is not easy on the mother easy. Emotionally or physically. You would have to deal with your IV meds, pumping, dealing with an ANGRY SAD CRYING baby who won't take a bottle and your own emotions on the matter.

If I were in your shoes (and I have been there just not IV meds - oral and inhaled) I would nurse her. Give her some baby probiotics (and most definitely take some yourself) and just nurse her like usual. I'm sorry but there is no way I'm relying on my CF doc for ANY breastfeeding advice. Dr. Hale is #1 authority in my book and if I had additional questions I would ask a lactation consultant. Most hospitals have them and you can just call and ask to speak to one.

My daughter is now 2.5 and I have no plans to stop nursing her till she is ready, whenever that may be. She was VERY ill a few weeks ago and I honestly believe that nursing was the only thing that kept her out of the hospital. She had a horrible stomach bug on top of a cold. She threw up for over a week. But I was able to keep her hydrated just enough and knew that she was getting at least some nutrition and electrolytes from nursing. She lost 2-3 lbs which when you are only 25 lbs to begin with is a lot!

Let us know how everything is when you get a chance.
 
K

Keepercjr

Guest
No!! You don't need to wean her and you don't need to stop nursing. She won't absorb any of that tobra. I understand that docs want to err on the side of caution but when they know nothing about what they are talking about it really irritates me! They just do not understand the importance of a nursing relationship. It isn't so easy just to say to your BABY "sorry you can't nurse anymore even though just last night you nursed and you won't understand but oh well doctor says so". And it is not easy on the mother easy. Emotionally or physically. You would have to deal with your IV meds, pumping, dealing with an ANGRY SAD CRYING baby who won't take a bottle and your own emotions on the matter.
<br />
<br />If I were in your shoes (and I have been there just not IV meds - oral and inhaled) I would nurse her. Give her some baby probiotics (and most definitely take some yourself) and just nurse her like usual. I'm sorry but there is no way I'm relying on my CF doc for ANY breastfeeding advice. Dr. Hale is #1 authority in my book and if I had additional questions I would ask a lactation consultant. Most hospitals have them and you can just call and ask to speak to one.
<br />
<br />My daughter is now 2.5 and I have no plans to stop nursing her till she is ready, whenever that may be. She was VERY ill a few weeks ago and I honestly believe that nursing was the only thing that kept her out of the hospital. She had a horrible stomach bug on top of a cold. She threw up for over a week. But I was able to keep her hydrated just enough and knew that she was getting at least some nutrition and electrolytes from nursing. She lost 2-3 lbs which when you are only 25 lbs to begin with is a lot!
<br />
<br />Let us know how everything is when you get a chance.
 
K

Kristen

New member
Thanks everyone for your quick responses! I did a lot of research today - I called my daughter's pediatrician, my lactation consultant, and Dr. Hale's infant risk center. They ALL said it was safe to nurse while on IV Tobra (of course, they all used Dr. Hale's book as their reference).

My lactation consultant told me about Dr. Hale's infant risk center. You can call them and ask about the safety of meds while PG or nursing. They even faxed the info over to my doctor. They told me about the research studies published on nursing w/ Tobra, and they even explained that the half-life was 2-3 hours and suggested I wait three hours before nursing, just to be extra safe. It is a wonderful resource for moms with CF! From their website:

"The vision of the InfantRisk Center is to create a new body of drug information concerning the hazards and safety of medications and their use during pregnancy and during lactation," said Tom Hale, Ph.D. "Ultimately, we wish to funnel this information into an effort to extend and enhance our knowledge of the use of medications and other environmental chemicals in pregnant and breastfeeding women".

Their phone number is on their webpage: <a target=_blank class=ftalternatingbarlinklarge href="http://www.infantrisk.com/
">http://www.infantrisk.com/
</a>
Anyway, after talking it over with my husband, we decided I would do my Tobra at night (I am on it once a day), and then I would have 10 or so hours until I would have to nurse again. I'm also going pump and dump about three hours after administering Tobra, just to be extra safe.

I feel so much better about everything now. Caroline, everything you listed is exactly how I was feeling, especially the part about my daughter not understanding why I couldn't nurse her - the thought of having to do that broke my heart. I'm so glad that I don't have to!
 
K

Kristen

New member
Thanks everyone for your quick responses! I did a lot of research today - I called my daughter's pediatrician, my lactation consultant, and Dr. Hale's infant risk center. They ALL said it was safe to nurse while on IV Tobra (of course, they all used Dr. Hale's book as their reference).

My lactation consultant told me about Dr. Hale's infant risk center. You can call them and ask about the safety of meds while PG or nursing. They even faxed the info over to my doctor. They told me about the research studies published on nursing w/ Tobra, and they even explained that the half-life was 2-3 hours and suggested I wait three hours before nursing, just to be extra safe. It is a wonderful resource for moms with CF! From their website:

"The vision of the InfantRisk Center is to create a new body of drug information concerning the hazards and safety of medications and their use during pregnancy and during lactation," said Tom Hale, Ph.D. "Ultimately, we wish to funnel this information into an effort to extend and enhance our knowledge of the use of medications and other environmental chemicals in pregnant and breastfeeding women".

Their phone number is on their webpage: <a target=_blank class=ftalternatingbarlinklarge href="http://www.infantrisk.com/
">http://www.infantrisk.com/
</a>
Anyway, after talking it over with my husband, we decided I would do my Tobra at night (I am on it once a day), and then I would have 10 or so hours until I would have to nurse again. I'm also going pump and dump about three hours after administering Tobra, just to be extra safe.

I feel so much better about everything now. Caroline, everything you listed is exactly how I was feeling, especially the part about my daughter not understanding why I couldn't nurse her - the thought of having to do that broke my heart. I'm so glad that I don't have to!
 
K

Kristen

New member
Thanks everyone for your quick responses! I did a lot of research today - I called my daughter's pediatrician, my lactation consultant, and Dr. Hale's infant risk center. They ALL said it was safe to nurse while on IV Tobra (of course, they all used Dr. Hale's book as their reference).
<br />
<br />My lactation consultant told me about Dr. Hale's infant risk center. You can call them and ask about the safety of meds while PG or nursing. They even faxed the info over to my doctor. They told me about the research studies published on nursing w/ Tobra, and they even explained that the half-life was 2-3 hours and suggested I wait three hours before nursing, just to be extra safe. It is a wonderful resource for moms with CF! From their website:
<br />
<br />"The vision of the InfantRisk Center is to create a new body of drug information concerning the hazards and safety of medications and their use during pregnancy and during lactation," said Tom Hale, Ph.D. "Ultimately, we wish to funnel this information into an effort to extend and enhance our knowledge of the use of medications and other environmental chemicals in pregnant and breastfeeding women".
<br />
<br />Their phone number is on their webpage: <a target=_blank class=ftalternatingbarlinklarge href="http://www.infantrisk.com/
">http://www.infantrisk.com/
</a><br />
<br />Anyway, after talking it over with my husband, we decided I would do my Tobra at night (I am on it once a day), and then I would have 10 or so hours until I would have to nurse again. I'm also going pump and dump about three hours after administering Tobra, just to be extra safe.
<br />
<br />I feel so much better about everything now. Caroline, everything you listed is exactly how I was feeling, especially the part about my daughter not understanding why I couldn't nurse her - the thought of having to do that broke my heart. I'm so glad that I don't have to!
 
M

mamaScarlett

Active member
Thats wonderful Kristen!
Hope you are feeling better very soon. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
M

mamaScarlett

Active member
Thats wonderful Kristen!
Hope you are feeling better very soon. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
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