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I have a 2 week postpartum mom who is concerned that her baby has been sleepy since she's been started on hydralazine and novasc. Norvasc is listed as L3, use with caution in lactating women. Hydralazine is L2, but sedation is something to be considered. Are there better options for medication for this mom?
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Hi, thanks for your post.
Probably the first thing to do is to give the baby a 2 day drug holiday to determine if it really is meds via breastmilk that are causing the sedation. Every baby is different and I often find that moms don't have a good handle on the baby's behavioral baseline at 2 weeks since there are so many changes during that period. I would hate to suggest changing mom's meds if they weren't to blame for the problem.
The hydralazine transfers into milk in such small quantities that I would be very surprised if it were having any effect on the baby. Norvasc (amlodipine) is not well studied in breastfeeding women, but we do know it has a very long half-life and high oral bioavailability, which could cause problems in susceptible newborns. Consider methyldopa, metoprolol, or propranolol as alternatives, at least until the baby is 9 months old.
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