I've been told to stop breastfeeding :(

[PickledMoomin]

DS is seven months old and other than some food since weaning, he's been EBF.
I was admitted to hospital today and diagnosed with Bell's Palsy and possibly shingles. I've been prescribed Prednisolone 60mg daily and Aciclovir 1000mg daily.
The doctor at the hospital told me it was unsafe to continue to BF when taking more than 40mg of Prednisolone steriod. I asked if there was an alternative suitable for breastfeeding and was told that this was not his area. DS also has suspected dairy allergy and I requested that the doctor call peads to discuss medication. I was informed again that I should stop BF and told to give him a dairy-free formula.
The doctor called my GP for a formula prescription but there wasn't a doctor there. He decided that he would write a prescription for some formula along with the treatment for me and I took it to the pharmacy. I explained that I was not happy about giving up BF and asked if there was an alternative. I was told that it'd take a few days to find out and that I could not BF until then anyway. I was so upset that I left and DP collected the medication for me (without the formula - the presciption wasn't in DS's name and so she couldn't get it for us. DP was furious but the pharmacist said it wasn't her problem....he came away commenting that our baby could not be BF and now not given formula)....
I'd intended to feed for much longer. I've been in tears all afternoon at the thought of giving up. I started the medication and haven't fed DS. We bought some formula and will deal with the bottle battle this evening. I feel so let down .

I do sympathise, having been unable to breastfeed at all and having always planned to. Rediculous re the prescription problems etc! Sending you positive vibes.

How horrid for you. Sounds like theres been a complete lack of support and sympathy.

I don't know from your post how long you're going to be on medication for and how long the medication stays in your system for, but could you express and dispose of the milk for this period you need the drugs/ they are in your system?

The Breastfeeding Network Drugline may be able to give you more information if you had not come across this before. It is run by a registered pharmacist and is designed to be used in consultation wtih your HCPs (as the site disclaimers make clear). They have up to date information on which drugs and doses can be used by a bf mother. The age of the baby will have some bearing usually. You could also speak to a bf counsellor about how you are feeling (not someone telling you to not to give up) but someone to listen to you talk about your feelings of disappointment around this issue. I hope whatever treatment you get is helpful for you and whatever the outcome you did give your baby loads of breastmilk which is a good thing

kellymom info here

Info on prednisolone while bfing including alternatives to consider.

Info on acyclovir while bfing.

0844 412 4665 is the number for the breastfeeding network who can give you up to date info/advice on drugs while bfing, how long the drugs will be in your milk for and the best way to proceed.

I'm so sorry you were badly supported.

If you find you cant have alternative drugs; keep your supply going by expressing and disgarding the milk while you are on them. This will be a reasonably short period when formula may be the only way but you could get back to breastfing once the drugs are out of your system. Hospital doc could have phoned hospital pharmacy to ask advice re alternative drugs. You may wish to report your treatment by this doctor as he could use some 'education' - (prednisolone especially) is a very common drug.

Pump & dump whilst on these drugs. Poor you though as bf is more than just the milk.

Thank you all so much for your support.

I've spoken to somebody. She suggested maintaining my supply whilst on the medication (6 days until I drop to 40mg when it's safe) by expressing for 20 mins, 6-8 times a day including two night sittings.

DS took 4 ounces of formula before bed. Five and a half days to go......

You poor thing you feel like crap already and someone says this

Your supply will come back up when you are better. A well mummy is important too.

Had to pump n dump for 7 days when DD was tiny (under 10 weeks so my supply not nearly so established). Can't remember what the drugs were, didn't know about he drugline so did not pursue it. Anyway she got back on the breast when the drugs were finished and went on bf for ages so at 7 mos with a good supply it should be straightforward. Good luck with the treatment

Keep on pumping no matter what, and see if you can find another Dr.

Did you get any choice in the treatment? You don't have to take treatment for Bell's palsy although there is fairly good evidence that steroids will increase your chances of a full recovery. The evidence for aciclovir is weaker. If you take nothing you have a roughly 15 in 20 chance of a full recovery. Taking steroids improves this to 17 in 20.

nothing to add other than my sympathy, sounds like you were very poorly supported. good luck with the expressing, hope you get well soon

Thanks, whomovedmychoc. I'm hoping I'll soon be back to normal.

MrsSantos - so reassuring to know that you managed to keep your supply. You did amazingly well. Were there any issues with getting her back on? I have this fear that he'll forget how to feed.

mathanxiety - hope to never see the doctor again. Not likely to as he was SHO at hospital.

Liath - nope, no choice given. I asked for alternative medication and scaremongered into taking it...in so many words he told me I'd risk permanent damage if I didn't start the meds asap. The odds weren't explained - didn't realise there was so little difference in stats.

Have just pumped around twelve ounces and will get up a few times in the night and have another go.

Prednisolone
CASRN: 50-24-8
For other data, click on the Table of Contents

Drug Levels and Effects:

Summary of Use during Lactation:
Limited information indicates that maternal doses of prednisolone up to 50 mg produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants. With high maternal doses, avoiding breastfeeding for 4 hours after a dose should markedly decrease the dose received by the infant. However, this maneuver is probably not necessary in most cases.

Acyclovir
CASRN: 59277-89-3
For other data, click on the Table of Contents

Drug Levels and Effects:

Summary of Use during Lactation:
Even with the highest maternal dosages, the dosage of acyclovir in milk is only about 1% of a typical infant dosage and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required

These are the summaries from an American website toxnet.nlm.nih.gov/cgi-bin/sis/search for both meds.

I would have used this source (along with others) if I had been asked for info. Obviously it is difficult for me to comment on your case without having all clinical details. but bear in mind your son is 7 months old and therefore his ability to metabolise meds is much better than a newborn and your milk is not his sole source of nutrition.

It is a shame it is the weekend otherwise I would have suggested phoning the pharmacy dept and asking again.

Just wanted to offer my sympathies- and agree pump & dump best option- I'm sure DS will be able to resume BFing once you've finished the meds.

Have had Bell's palsy too and the steroids certainly helped enormously. But it does make me very that they were so unsupportive about alternative meds suitable to take while BFing. I had similar situation after DD2 was born- needed to take an ACE inhibitor which was not recommended while BFing but no other option- DD2 was only 6 days old- eventually a consultant came to discuss it as was mortified having started BFing to have to stop due to meds and he said i could keep feeding as in his opinion very little would get through to DD2 and benefits of BFing outweighed risks in this case- but did say there were no trials of this drug in newborns so it was my decision. We carried on BFing and I was on the meds for 3 weeks- DD2 was fine. Just so lucky to have had a doctor who could see my quandry and have a decent chat about it.

Hope DS takes to the bottles and formula ok and then goes back to BFing ok too. The lactose intolerance thing is a whole other can of worms...but I believe you can still BF a lactose intolerant baby so long as you cut out dairy, but not an expert I'm afraid!

Good luck and hope the Bell's palsy clears up soon, it's such a miserable condition. x

Sorry to hear you are not well and have been so poorly treated. Sounds like it would be worth complaining about this doctor if/when you feel up to it. Maybe via your local PALS service?

I've had Bell's Palsy and had no treatment apart from being given an eye patch and some eye drops.

Are the drugs for the shingles?

Thevelveteenrabbit - That information helps so much. I've been thinking along those very same lines. I'm taking 60mg so slightly higher than the 50mg dose discussed. However, DS was two weeks overdue, his weight has always been above average and he has been in good health since birth. I'm taking all twelve tabs (each is 5mg) in one dose rather than at regulary spaced intervals and wonder whether it would be possible to be cautious and wait 4 hours before BF rather than not BF at all. I think I'll continue to pump and dump until Monday when I can speak to somebody.

Jumpingjellyfish - Thanks for sharing - that must have been very stressful for you and it's good to hear that the doctor was understanding. DS has so far refused to take the formula from me but has taken a few ounces per feed from DP. How long did your Bell's Palsy last? Did you make a full recovery?

ItNeverRains - I think it'd be a good idea to discuss the treatment I was given, if only to offer some education on the importance of supporting a patient who wishes to continue BF.

SunshineOnLee and Cece - They grade the Bell's Palsy through a few examinations and mine was graded as 3. I'm not sure whether this makes a difference to the treatment offered. The antiviral is for the 'shingles' (which he said could be the cause of the Bell's but he wasn't firm in his diagnosis since I was showing no symptoms of shingles other than blisters in my mouth).

I expressed at 830pm, 12am, 430am, 8am, 1230pm and hope to express again at normal bedtime feed. That'll mean six x 20 mins in 24 hours. Hope this is enough to maintain supply.

A few examinations!

I saw the dr once to be diagnosed and then about a week later, when I started getting pains in my face. It was then she signed me off of work. They had forgotten to tell me not to go to work initially!

Well done for the expressing. Keeping it up during the night is very important afaik.

I wonder how long you had symptoms before you got the prescription? AFAIK, the ideal window to begin any medication regimen for Bells Palsy is within 72 hours of first onset of symptoms. Not sure if the efficacy of the drugs is proven or otherwise beyond that time.

Pickled sounds like you are doing very well with the expressing. I think six times per 24hours should be absolutely fine, especially as you're doing a few at night which is most important- generally try to express whenever he would normally feed and for around twenty mins. Sorry to hear DS is struggling with the formula (I have a DD2 who is the same) but hope this won't have to be for long.

How are your symptoms? I had Bell's palsy when I was 16, so a good while ago now! It took around a week to clear up after starting steroids, though I think improved quite quickly... Everything resolved (i.e. I could close my eye ok, smile and not dribble etc etc!) but I have been left with some redness that side compared to the other, though I'm naturally rosy in complexion so don't think it's overly noticeable- though if I've had a few drinks bizarrely that side of my face flushes quite a lot more than the other! Still, nothing to be overly concerned with!

Hope you get more support once you can talk to medics tomorrow, and hope you feel much better soon x

how are you doing pickled??
well done on the expressing, it is such a pain

Still expressing but finding it very tiring. Last night I set my alarm to express at 215 and didn't get back to sleep until 545 (DS was difficult to resettle) and was up again at 6 to express.

Bell's is very much the same though a few people have said that they can see a slight improvement. I'm still managing to express around 30 ounces in 24 hours which I guess is more than he would normally take. I've booked in for some reflexology on Thursday (don't think it'll help with the Bell's but have heard it's good for milk production) and a lovely friend has some fennel for me to take.

Two more days of 60mg and then I can drop to 40mg and feed again. Didn't have the energy to see the GP today - he's difficult to talk to at the best of times so will continue expressing for another two days to be on the safe side.

Stealth - am ok. Just really fed up of looking so awful. I feel totally exhausted today and just want to be able to eat (yum!) and drink with ease again.

JumpingJellyFish - Relieved to know that you recovered so quickly. Have been invited to a wedding on Saturday so I live in hope that I'll be able to attend. We'll see though.

Mathanxiety - I'd been feeling a little poorly since Monday but the Bell's symptoms didn't begin until Thurs pm. I was sent to hospital on Friday am and began the meds soon after.

Cece - I think it's a postcode lottery with the treatment. I've spoken to lots of people who weren't offered any medication and still went on to make a fully recovery. I think I was sent to hospital but there was NAD on my eardrum and this is normally seen in a patient with Bell's.