re: OT Parents - how would you handle receiving conflicting medical info from doctors?

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Pharmacist prevent a lot of people from being killed by doctors so I would take that into consideration.

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Pharmacist call mainly because the drug isn't covered by Medicaid

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Considering that the pharmacist is gonna be the one to know the most about the medication...

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Wow. Just wow.

Realize you are asking the most loaded of question to various healthcare professionals. Is there an antibiotic for UTI that does not carry a pregnancy or lactation warning? If they don’t now wait for it.

Go with the OB recs. EVERYBODY will default to your OB and later a pedi. Realize as these people give you “answers” they are giving you the answer that covers their arse. A pharmacist WILL answer most every medication question you have. Until a 10 day Old is involved. Then they are gonna tell you to stop until you talk to your doctor.

Pedi gave you a good answer. You have to weigh risks of the minimal chance your baby gets jaundice vs the risk of a mother going untreated and becoming septic. Your baby is not nursing from a septic mother. Your wife IS sick. Your baby MIGHT get jaundiced.

Lactation experts treat breast milk like a Trappist Monk treats beer. It is sacred. You don’t taint tit nectar with anything. Sonsacred that she would instruct your wife to go with formula, which she spends half her day championing against.

I think the infant risk hotline confused ingestion vs breast milk peak concentrations. As in your baby accidentally ingested Macrobid or a person gave the med by mistake. Like an overdose.

Macrobid is given to many pregnant and nursing moms. Switching from breast to bottle back to breast is gonna be a bitch. Shitty diapers or no diapers and bitten and cracked nipples. Read about pumping and dumping where Macrobid is concerned. Dump when Macrobid reaches its peak blood levels in your wife. That will virtually mirror breast milk. Dump at that time. Otherwise I’d feed the baby breast milk.

Breast feeding is amazing for the baby. Every other kid you see will have green shite continuously from their nose. I swear my son had one booger while breast feeding. When my wife finally stopped, BAM. Runny nose.

Every few months there is a new study and a new paper. Zofran was safe during pregnancy, now not so much. shite, Tylenol is being suggested to stop now. That used to be the pregnancy joke of what a mother can take.

I can probably count with both hands and my pud the number of things that are considered safe by a concensus of sources. That is still just concensus. Some journal somewhere is going to say “wait a minute”.

You again are asking one of the most loaded questions in medicine to multiple people across multiple disciplines who no doubt have varying levels of experience.

My advice, take the damned Macrobid. A wife who is sick as hell is no use to a baby and she’s not nursing anyway. Let this experience be a lesson to you and the wife as to just how much she should not be putting into her body during this time. In 6 months your wife will be pounding margaritas with girlfriends and pumping and dumping but still wondering why your baby slept “so well last night, did I cut it too close?”

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. BTW pre pregnancy pics of the wife would help

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Lith, you are my favorite doctor.

OP: if the drug has a max shelf life of 4 hours in breastmilk can’t your wife just pump and dump at the four hour mark and feed in between? How often is baby’s feeding now, and do you have baby on a schedule yet?

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OP: if the drug has a max shelf life of 4 hours in breastmilk

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If that’s accurate. I’m only going by info found online. Some sources say it’s run through the urinary tract within an hour. One source said it’s at its peak in breast milk in 4 hours but that wasn’t a scientific study. A study led by Jamie Zao (easily found online) discussed various studies on levels of Nitrofurantoin found in breast milk. All of the studies showed a very small amount transferred to breast milk. She concluded that while a different antibiotic would be preferred, the risk was too low to warrant stopping breast feeding while taking the medicine.

And she feeds every 2-3 hours. No schedule yet but she’s consistent.

So let me get this straight. You got the same info from two doctors ok to take the med, and now you’re going with the lactation specialist and pharmacist????

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All of the studies showed a very small amount transferred to breast milk. S

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Sure. Think about it. I AM IN NO WAY ADVOCATING THIS. if you and your wife were trashy and went out pounding drinks, breast milk concentration would equal BAC. What’s a 0.08% Beer gonna do to you? Even a blotto 0.25-0.3% is probably not gonna do much. Is it smart? frick no.

Same with the antibiotic. Your wife isn’t taking the med and it’s immediately going into her breast milk. It is hitting the bloodstream and bthen breast milk

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Wife got diagnosed with a UTI today. Her OB prescribed Macrobid (Nitrofurantoin), which carries a warning for breast feeding. It’s considered an L2 drug and is potentially dangerous for babies less than one month old. Our baby is 10 days old.

Her OB’s nurse said it was fine and to watch for any signs of jaundice. The doctor had left for the day so we couldn’t consult with her.

My wife decided to get some other opinions.

The pharmacist said to switch to formula for seven days then go back to breast feeding after the antibiotic is over. She was concerned about a 10 day old baby getting any of the drug in her system.

The pediatrician said she recommended formula but worried about the baby not adapting to the new food and thus risking losing weight while messing up her ability to breastfeed. She said she had no problem with my wife continuing to breast feed while taking the medicine but to watch for reactions.

The hospital lactation specialist said absolutely not to taking Nitrofurantoin and breast feeding.

The Infant Risk Hotline said it was fine but mentioned that Macrobid has a half life of 30 minutes to an hour so waiting two hours before breast feeding was ideal.

I just read that Nitrofurantoin is at its peak in breast milk at 4 hours after taking the medicine.

We’re going ahead and continuing to breast feed on the medicine but it’s frustrating getting so many different opinions. How would you handle it?

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Holy shite, that's a lot of conflicting info.

I'm just going to come out and ask, have you considered putting the baby up for adoption?

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I asked my doctor a super simple question one time; “can I have dairy with that medication” for the sole reason I had gotten sick from a similar one before. His answer “I’m not entirely sure, is that something you read online? I’d recommend asking the pharmacist, theyre the medicine experts”

Trust the pharmacist.

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That is an example of a bad doctor not an example of a good pharmacist.

I have never met a pharmacist that knows as much about the specific drugs that I prescribe daily. A pharmacist (like a general practitioner) has hundreds of drugs they encounter on a regular basis. They have a shallow understanding of all of them.

Specialists have much less “numbers” of meds to follow outcomes and far more daily experience.

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Pharmacist prevent a lot of people from being killed by doctors so I would take that into consideration.

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this and this and this!

I would call the doc on duties off hours paging number and ask to be put on a safer antibiotic while breastfeeding. If it were me I would kindly suggest Cipro to the doc and watch the baby for any allergic reactions which is rare.