Mother to be Ordered by Court to Stop Breastfeeding?
Via The Lactivist, I learned of this story of a Minnesota woman who is being told by a court that she should stop breastfeeding her 15-month-old son because of three medications she is taking, Topamax, Baclofen (spelled “Baclofin,” incorrectly, in the piece), and Ambien. She and her husband are involved in a custody battle, and the husband asked the court to appoint a guardian in the best interest of their son. The resulting report recommended that she stop breastfeeding in order not to cause developmental delays in her son, although the investigator in the case is not a medical expert and other sources suggest that the medicines she is on are okay with breastfeeding. If the judge agrees with the investigator, it may result in a court order to cease breastfeeding.
So what *do* medical experts say about these drugs? The freely available LactMed database provides just this type of information. It states the following:
Topiramate (Topamax) – Limited information indicates that maternal doses of topiramate up to 200 mg daily produce low levels in infant serum. Monitor the infant for drowsiness, adequate weight gain, and developmental milestones, especially in younger, exclusively breastfed infants and when using combinations of anticonvulsant or psychotropic drugs.
Despite the recommendation for monitoring, no reports of adverse effects on breastfed infants are reported in the summary.
Zolpidem (Ambien) – Because of the low levels of zolpidem in breastmilk and its short half-life, amounts ingested by the infant are small and would not be expected to cause any adverse effects in breastfed infants. No special precautions are required. There were no published adverse effects on breastfed infants.
Baclofen – Limited information indicates that baclofen has low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. Monitor newborn infants for signs of sedation. There is only one reported adverse event, of a newborn exposed in utero.
None of these documents suggest that breastfeeding should be halted, much less by court order, when these drugs are taken. At the most they recommend monitoring of younger babies. There may be more to this story, but as it stands it appears to be outrageous and unfounded.