Re: Asymptomatic bacteriuria
From: Jim Connerth (babydoc@apex.net)
Sun Apr 23 10:54:38 2000
"Kathi Wilson, BHSc, RM" wrote:
> At Sun, 23 Apr 2000, Geffrey Klein, MD wrote:
> >
> >per the PDR
> >
> >Although it is classified as a pregnancy category B drug for use during
> >pregnancy, nitrofurantoin can induce hemolytic anemia in G6PD-deficient
> >patients and in patients whose RBCs lack sufficient quantities of reduced
> >glutathione. Since neonates exhibit this latter condition, generally it is
> >wise to avoid the use of this drug during late pregnancy; however,
> >hemolytic anemia in the newborn as a result of in utero exposure to
> >nitrofurantoin has not been reported. Nitrofurantion is contraindicated in
> >pregnancy at term (38-42 weeks gestation), during labor or obstetric
> >delivery, or in neonates < 1 month old. Nitrofurantoin is distributed into
> >breast milk and should be used with caution in breast-feeding women,
> >especially in infants with G6PD deficiency.
>
> I sometimes find that "official" drug books like the PDR (south of the
> border) or the CPS (up here) tend to be overly cautious when discussing
> drugs and breastfeeding -- to the extent that we sometimes have
> physicians telling women that they must stop breastfeeding or pump and
> dump if they take *anything*. (The one that usually kills me is women
> being told to stop to take ampicillin -- uh, what was that she had
> intravenously during labour?? What did they give that kid in the NICU?)
>
> I like Briggs, or Thomas Hale's Red Book for more evidence based
> information on drugs and lactation. Here's a site that someone recently
> posted on one of my lists (hope it wasn't here, or I'll feel redundant):
>
> http://prl.humc.edu/obgyn/public/tearatog/Riska-c.htm#A
>
> I also use Motherisk in Toronto a fair bit and our locally based fetal
> risk assessment programme when getting accurate information about drugs
> and breastfeeding and/or pregnancy.
>
> In reality, there isn't a whole lot that women can't take while they're
> breastfeeding, although I wholeheartedly agree that you have to take the
> entire health hx into account.
> So TRUE---I seem to remember a study that stated <1% of medication secreted
> in breast milk(few compounds actively taken up)---
> --
> Kathi Wilson, BHSc, RM
> Thames Valley Midwives,
> London, Ontario, Canada
> mailto:wilsonk@gtn.net
> http://tvm.on.ca
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