I am caring for a mother of a 32 week preemie in our NICU that is taking Bentyl on a PRN basis for cramping, bloating etc. With this being an L4 and the infant being premature our Neo's are reluctant to use milk when she is taking this med. Since she takes it on a PRN basis I consulted our Ped's Pharm D and he suggested she pump and dump 24 hours after dose to make sure med is cleared from her system.
What other meds can she suggest to her GI doctor in the meantime? Is our recommedations appropriate for this Mom?
Lori Lindsey, RN IBCLC
In answer to your questions, the biggest concern with this medication is apnea in the infant.
This particular medication has a half-life of 9-10 hours. In six half-lives, (60 hours), almost all the medication will be out of mom’s system. In the 24 hour period you mention, approximately 75% of th medication will be out of mom’s system.
The infant must be monitored very closely for apnea, and this would be of great concern if mom continues to use this medication after the infant goes home. Generally, infants are extremrly sensitive to anticholinergic medications, such as Benyl. This is particularily true in a premie and during the neonatal period.
I’m sorry, I don’t know of an alternative medication to suggest.
If you have any further questions, please feel free to call us at the InfantRisk Center at 806-352-2519, Mon-Fri, 8am-5pm CDT.
Colleen Peace, BSN, RN
InfantRisk Center, TTUHSC
Hello, I've stumbled across this forum while researching Pentasa & breastfeeding and wondered if you can help. I've only recently been diagnosed & my doctor has prescribed 1g oral Pentasa tablets twice a day. My daughter is 6 months old and exclusively breastfed (have just started to introduce solid food). When I asked doctor about breastfeeding he was unsure and had to look information up in a book and just told me to look out for diarrhea, if I noticed any I should stop breastfeeding which I really don't want to happen and is easier said than done.
Dr. Hale rates the medications by risk. L1 medications are the most compatible with breastfeeding. This scale goes to L5, which are the medications that should be avoided while breastfeeding.
Pentasa is rated an L3. The infant will receive anywhere from 0.1% - 8.8% of your dose of the medication.
My understanding is you take a total of 2 grams per day. This is probably compatible with breastfeeding. Your physician was correct in that you should monitor the infant for watery diarrhea. If that should happen (it is rare that this happens), please be sure to contact the pediatrician and be guided by what he/she recommends.
If the infant does get watery diarrhea, it might be necessary that you start feeding the infant half breastmilk and half formula. You could then gradually titrate up with breastmilk until you are once again breastfeeding 100%, as long as the infant’s system tolerates the medication.
Once again, it is rare that the infant would get watery diarrhea while mom is only taking a total of 2 grams of this medication.
If you have any additional questions, please call us at the InfantRisk Center at 806-352-2519 so we can discuss this with you on a more individual basis. We are open Mon-Fri from 8:00am-5:00pm, CST.
Colleen Peace, RN, MSN
TTUHSC, InfantRisk Center