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COElizabeth
02-28-2003, 09:29 AM
I really need advice. Based on family history and my recent eye exam, I am expecting that an opthalmologist will prescribe medication for glaucoma. I'm really worried that the doctor won't have much experience treating pregnant or nursing women since this isn't a condition that is common among younger women. I am worried that he or she will tell me to wean immediately. That would be really traumatic, obviously, and not what I want, though of course I want my baby to be safe. I did a little research on the internet, and it seems that most of the drugs are category C, with not much data on effects. I found the American Academy of Pediatrics table of drugs considered compatible with nursing and couldn't find any of the drugs listed there. I like my pediatric practice but haven't so far found them very helpful on these issues (they told me to ask my OB the last time I got a prescription). Does anyone have any good advice or resources? I'm crying thinking of the possibility that the doctor will tell me to wean immediately - James doesn't even take a bottle well!

Elizabeth
Mom to James
9-20-02

Momof3Labs
02-28-2003, 10:01 AM
Elizabeth,

I have no information for you, but I wanted to let you know that I completely understand how you feel! How traumatic to be told that you might have glaucoma, and then to think that you might have to wean before you and James are ready. That's a double whammy, and makes it all that much harder to deal with. :-(

I hope that your doctor can find a solution that works for you, and doesn't force you to wean James.

egoldber
02-28-2003, 11:15 AM
I am really surprised that your ped's office doesn't know what medications are safe to take when breastfeeding! You may want to contact a lactation consultant, they generally know these things, or have access to the reference manuals. Your OB would know which medications are safe to take when pregnnant, but many things that are NOT safe when pregnant, are perfectly safe when nursing.

I also did a quick search on "glaucoma medication breastfeeding" and found this link to the Glaucoma society in the UK. http://www.iga.org.uk/fs_l23.htm

HTH,

Karenn
02-28-2003, 01:01 PM
Elizabeth,
That's a hard situation. There have been a couple of times in the last few months when I have possibly needed to take prescription meds. On one occasion, I talked to the lactation consultant, and another time my OB. They both had information about what I could and couldn't take when I was nursing.

If I were in your situation, I'd talk to a lactation consultant. All of the ones that I have interacted with will do just about anything to keep you nursing longer if it's at all possible. If there's away around weaning, I bet they'd know about it.

Good luck.

sntm
02-28-2003, 04:37 PM
Elizabeth,
If you are worried, there are lots of glaucoma meds that are topical eyedrops and should not have much systemic absorption (and therefore, not much chance of passing into breast milk.) That is probably one of the reasons that the studies haven't been done -- the potential risk should be pretty low.
I agree to check some further resources. You can always have your ophthamologist call a glaucoma specialist or university where they might know more about the meds in younger patients.

shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03

KathyO
02-28-2003, 05:58 PM
One of the big problems in getting hard facts in this area is that (of course) researchers are naturally reluctant to expose infants to drugs when they really don't know what the effects will be. It leaves moms who HAVE to take those drugs between a rock and a hard place.

Here is a page on breastfeeding and drugs from the Motherisk program at Toronto's Sick Children's Hospital:

http://www.motherisk.org/breastfeeding/index.php3

They do most of the research that gets done here, and I've found them very helpful. They specialize in "the rock and the hard place" - like antiepileptic drugs, and blood-pressure-control drugs, and other stuff you just GOTTA take, if you need it. According to their FAQ, they also field calls from the US, so you can try the toll-free number listed on their Contact Us page.

When they do initial intake (ie. answer the phone), they may start off by quizzing you about your alcohol/nicotine habits etc. It's nothing personal and it's not about judging YOU - they are constantly collecting data on usage patterns in the population, and they also like to have a profile on hand in case you call again. They really are nice people. They don't have an answer for every single thing, but they've got more than almost anyone else...

Hope that helps! For what it's worth, my grandmother had glaucoma for most of her life. It was controlled with eye drops, and when she died at 92, she could still do the crossword and watch hockey games.

Best,

KathyO

sparkeze
03-01-2003, 03:15 AM
Another place you could ask is the La Leche League helpline. They have a pretty comprehensive list of what medications are safe and what are not so they might be able to tell you where on the list the medication you need to take is.

I hope you find the answers!

parkersmama
03-01-2003, 06:41 PM
A lot of great ideas here! Another one that might help you...my dad is a pharmacologist and the pharmacy school where he teaches has a Drug Information Center(DIC). He says that the students and faculty who staff the DIC love to field calls that they can research like this to help them and you at the same time. If you have a pharmacy school in your state, you might try that. Another idea is to call your local poison control center and see if they have any information. They are often very helpful with drug info.

I've experienced the same thing with doctors not knowing what is safe. Both my pediatrician and OB have sometimes not know what's safe to take while bfing. Lucky I've got my own personal research pharmacist! LOL!

Anyway, I think it's great that you're not willing to give up easily. Good luck in finding a workable solution!

Denise
mom to:
Parker, 9/1/1997
Wesley, 3/9/2000
and #3 (a girl!) due 4/29/2003

COElizabeth
03-01-2003, 07:08 PM
Thanks so much for the ideas, everyone. I called our ped's office, who this time referred me to the hospital's lactation program. The woman I spoke with found a blurb on glaucoma drugs in a book by Dr. Thomas Hale. He is a pharmacist or pharmacologist (not even sure of the difference myself) and apparently has done a lot of work on analyzing various drugs and how much really gets into the milk, etc. She said his work has been a tremendous help because it gives LCs something to go on besides the PDR (Physicians' Desk Reference), which basically says you can't take anything. She is mailing me the chapter with info on the various glaucoma drugs. She also mentioned a technique I read about on the Glaucoma Research Foundation web site. Apparently if you press the inside corner of your eye for several minutes after administering drops, much less medication is absorbed into the mucous membranes and then into the bloodstream. I plan to take the article to the eye doctor when I go. I have also asked my mom to ask her opthalmologist if she has any experience in this area and have asked my internist for advice. He is affiliated with the university's medical school and was good about asking his pharmacy contacts back when we were concerned about the effects of one of DH's medicines on fertility. I also plan to ask my OB her opinion when I go for my annual exam, which is on the 11th so will probably be before the eye appointment. And I will definitely take the Motherisk and LLL phone numbers as well in case we need to call either of those organizations. I will let you know the outcome, but thanks again for the advice and suggestions and empathy. They mean a lot to me - and James!

Elizabeth
Mom to James
9-20-02