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A patient reports she has historically taken N-Acetyl Cysteine to help treat her Trichotillomania and would like to know if she can continue this while breastfeeding her newborn. I have searched the Medication and Mothers' Milk online we have available through our health care system so as to provide her with complete information and have not found anything. I have searched online and found conflicting information. In general it appears that it would not be an issue, and as an IBCLC, I feel most things are a better choice than not breastfeeding (and then, formula feeding). However, I would like to give her some suitable information to bring back to her Pediatrician if needed.
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Andrealynn15,
I spoke with Dr Hale he would like more information. What is moms dose and did she take during her pregnancy, and was the baby full term and healthy ? Thanks,
Sandra Lovato R.N.
InfantRisk Center
806-352-2519 -
She was taking 1800mg daily while pregnant. She states she will willing to lower the dose if it is safer. Baby was born at 40 2/7 and is healthy.Comment
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Andrealynn15,
I spoke with Dr Hale he advised that this has a small molecular weight and will readily transfer into breast milk. He stated this has a bad odor of rotten eggs and baby may be turned off by the odor or taste of the milk. Also this medication reduces the anti-microbial effects of breast milk. He suggest if mom is able to reduce the dose it would be helpful, but would still suggest using half breast milk and half formula while taking this medication.
Dr Hale would like to test her breast milk if she would be willing to participate. Please call the InfantRisk Center at 806-352-2519 if she is able to provide milk samples and we will advise on the details. Thanks,
Sandra Lovato R.N.
InfantRisk CenterComment
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This question may be the patient and I just overthinking... but would you then suggest that she discontinue breastfeeding directly and pump and feed the half expressed breast milk/half formula? Do you have any information on the half-life of this medication? She is wondering then if she could continue to breastfeed directly half of the time and bottle feed formula half of the time, when would be the appropriate times of day to feed directly in consideration of when she takes the medication. This has become a deciding factor for her because she is currently exclusively breastfeeding her son directly without any bottles and would obviously like to continue to put him to breast half the time if it is an option.Comment
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Andrealynn15,
Mom can alternate every other feeding with formula and then put the infant directly to breast the other feedings. The biologic half life of n-acetyl cysteine in an adult is 5.6 hours, but unable to find a peak time. I would suggest she take the medication right after breastfeeding and then supplement with formula the next feeding and then she could put the baby to breast again for the following feeding and continue to alternate. I hope this helps.
Sandra Lovato R.N.
InfantRisk CenterComment
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Hi - I am in a similar, but slightly different situation. I have OCD and have been using NAC in combination with Zoloft at 200 mg. I started the NAC about 6-8 weeks ago - at 600 mg, and started to increase to 2400 mg (at that dose about three weeks ago). I have been on Zoloft for about a year. Before that I was on Celexa and was pregnant then (I can't remember exact dose - maybe 50 mg). I felt Celexa (and then Lexapro, actually) made my infant lethargic and we moved to Zoloft. At 200 mg it is not totally controlling my OCD. I breastfeed our infant still (who is now a bit over a year.) For the last three weeks, our infant has been incredibly fussy. After a week I called the ped, and did their various recommendations for a possible cold/teething, at week two I took him (no ear infection, etc.) to see the ped., and now at week 3 he is still fussy. It COULD be teething, but I'm concerned it's the NAC. Ped. says continue to breastfeeding and stop NAC and psychiatrist says to stop breastfeeding and use NAC. Since the most above, has Dr. H had anymore experience w/ NAC and formed any additional options/opinions? Thank you!Comment
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This info may help: [url] https://www.reddit.com/r/Trichsters/comments/102wnq/breastfeeding_and_nac/ [/url]Comment
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