UK Keratoconus Self-Help and Support Association

Hello All,

My wife is having Keratoconus in both the eyes. Her left eye is much affected. We have 9 Months old baby girl. I consulted 3 different cornea specialists in my city and I got different answers from them which are mentioned below:

Question: Can my wife breastfeed my daughter after C3R treatment?

1st Doctor: Yes, She can breastfeed after C3R treatment
2nd Doctor: After 15 days of C3R treatment, she can breastfeed
3rd Doctor: No, If you want to get positive results of the C3R treatment. Your wife will have to stop breastfeeding after C3R treatment for forever.

Now, I am totally confused and don't know what to do? I will be thankful if someone can help me on this question.

Thanks in advance,
Vipati

I have not had c3r but have had multiple eye ops under a general anesthetic n other ops inthe last nearly 4 years of breastfeeding my daughter

the advice from lactation consultants has always been "nurse once you feel strong enough to hold the child"

I would never ask a cornea specialist about breast feeding as it is not their remit, instead I trust my body and my judgement n that of lactation specialists

if you wait 15 days your wife is at risk of mastitus, blocked ducks or even milk supply diminishing not to mention breast avoidance by your small

and as for the 3rd view waht a heap of tosh! seriously! when will medical people quit being so dismissive of breastfeeding and waht breastfeeding parents wish for their child n when will they quit the bully scaremongering uneducated rubbish!!

vipati wrote:Question: Can my wife breastfeed my daughter after C3R treatment?

1st Doctor: Yes, She can breastfeed after C3R treatment
2nd Doctor: After 15 days of C3R treatment, she can breastfeed
3rd Doctor: No, If you want to get positive results of the C3R treatment. Your wife will have to stop breastfeeding after C3R treatment for forever.

Now, I am totally confused and don't know what to do? I will be thankful if someone can help me on this question.

I can see why you are confused as the answers are so different.

Searching the web it seems that the cross linking trials excluded pregnant and breast feeding mothers, although they did not say why. It may be that there is a lack of information about how cross linking affects pregnancy and breastfeeding. It could be that the riboflavin drops or the UV light is thought to be a problem, this could be why the second doctor suggested stopping breastfeeding for 15 days. Stopping for ever seems a bit extreme. Although it might be difficult to continue with this baby after 15 days I can't see how it can affect future pregnancies and breast feeding.

These are my thoughts, I think that you probably need to ask the doctors why they have given the answers they have.

Lia

I put this query to one of the crosslinking specialists at Moorfields and this is his reply -
'The actual CXL surgery itself (riboflavin, UV light) is irrelevant the moment you walk out of the operating room.
The only thing to consider here is the medication used post-operatively. You might expect to be prescribed a mixture of drops (antibiotics, steroids, anti-inflammatories, anaesthetic) with or without tablets (pain killers, vitamin C, doxycycline). As a general rule, the potential for drops to be absorbed into the body (and then into breast milk) is very limited. We routinely use all of the above drops in pregnant or breastfeeding women for other reasons (eg corneal ulcers), without problems. If this patient has been prescribed tablets as well, that is where potential risk lies. Paracetamol is safe, but non-steroidal anti-inflammatory drugs (eg voltarol, diclofenac, ibuprofen/neurofen) are contra-indicated in babies under 3 months. Above 3 months it's is ok. High-does vitamin C & doxycycline are used to encourage the epithelium to heal. Doxycycline definitely can not be used in pregnancy or children under 12 years of age as it discolours junior teeth - we don't use it at Moorfields after CXL, but I am aware other do. I'm not sure about high-dose vitamin c and breast-feeding.


2nd Doctor's response may be qualified when post-operative medication stops.
3rd Doctors response is nonsensical.'

I hope that helps. (I think clinical trials routinely exclude pregnant and breastfeeding women, whatever is being tested).

Anne

Thank you Anne Klepacz, Lia Williams and space_cadet for your helpful replies!!!

I also think that 3rd doctor is just trying to scare.

Well, full medication history may be much helpful. Please see below mentioned full medical history

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She got C3R treatment to her left eye on 20th Sept. 2016

She took "DAN-P" tablets twice a day for two days i.e on 20th and 21st Sept. - Then stops taking these tablets.

She is using below mentioned two eye drops 4 times a day after C3R treatment:

1. Zylopred - Below mentioned details for drops taken from it's website - http://www.allerganindia.com/index.php/ ... s/zylopred


Gatifloxacin + Loteprednol ophthalmic solution
DESCRIPTION:
Each mL contains:
Gatifloxacin Sesquihydrate IP equivalent to Gatifloxacin 0.3% w/v
Loteprednol Etabonate 0.5% w/v
Benzalkonium Chloride IP 0.005%w/v
Purified water IP q.s.
INTRODUCTION:
Loteprednol and Gatifloxacin Ophthalmic Suspension is a combination eye drops, which contains antibiotic Gatifloxacin & an anti-inflammatory agent Loteprednol.
DOSAGE AND ADMINISTRATIONE:
Apply one or two drops of Loteprednol + Gatifloacin suspension into the conjunctival sac of the affected eye(s) every four to six hours. During the initial 24 to 48 hours, the dosing maybe increased, to every one to two hours. Frequency should be decreased gradually as warranted by improvement in clinical signs. Care should be taken not to discontinue therapy prematurely.


2. Lubrex Eye Drops - Below mentioned details for drops taken from website - http://www.tablettree.com/p/lubrex-eye-drops/

Lubrex Eye Drops - Uses, Composition, Dosage, Side Effects & Reviews

Lubrex eye drops is considered safe to moisturize and relieve dry and irritated eyes. It provides temporary relief from burning, irritation and discomfort due to dry eye or exposure to wind, dust and sun. It is also proved useful in case of stressed or fatigue eyes. It also prevents further irritation of eyes. This medication contains Sodium Carboxymethylcellulose as its active ingredient which contains viscoelasticity which leads to the lubrication of eye surface. It also exhibits retentive properties which further increases the moistening of the eye surface. This medication includes a fast acting, long-lasting formula which mimics the soothing properties of natural tears.

Get relief from the irritated and dry eyes effectively with the use of Lubrex eye drops regularly. Buy it online at discounted prices at Tablet Tree.
Lubrex Eye Drops Uses

Sodium carboxymethylcellulose: It acts as an ocular lubricant which works by correcting osmolarity and pH distoration. It also restores the function of caliciform cells and also improves the metaplastic states of epithelia cells of conjunctiva. It has viscoelastic properties which provides lubrication to your eye surface.
Lubrex Eye Drops Composition

Sodium Carboxymethylcellulose……………………..0.5 % w/v

Stabilised Oxychloro Complex………………………..0.005% w/v
Lubrex Eye Drops Dosage

The recommended dose is as directed by the physician. Please consult your doctor and follow his or her recommendations. Please do not self medicate.
Lubrex Eye Drops Side Effects

The common side effects which can occur after taking this medicine are occasionally stinging, burning, red eyes and allergic reactions.

Other Information on Lubrex Eye Drops:
Pharmaceutical Form

Ophthalmic Solution
Precautions

It is for external use only and not for injection purposes
Do not touch the tip of container to any surface in order to avoid contamination
Do not use if the solution becomes cloudy or changes color
Discontinue the use of this medicine in case you experience eye pain, vision change, eye redness or irritation.
Inform your doctor in case you are pregnant or lactating

Overdose

There are no experiences of overdose by ophthalmic route.
Contraindications

This drug is contraindicated in patients who previously reported history of hypersensitivity to any of its components.
Package Content

One packet of Lubrex contains 10 ml eye drop

Manufacturer

Micro Labs Limited
Lubrex Eye Drops - Uses, Composition, Dosage, Side Effects & Reviews

Lubrex eye drops is considered safe to moisturize and relieve dry and irritated eyes. It provides temporary relief from burning, irritation and discomfort due to dry eye or exposure to wind, dust and sun. It is also proved useful in case of stressed or fatigue eyes. It also prevents further irritation of eyes. This medication contains Sodium Carboxymethylcellulose as its active ingredient which contains viscoelasticity which leads to the lubrication of eye surface. It also exhibits retentive properties which further increases the moistening of the eye surface. This medication includes a fast acting, long-lasting formula which mimics the soothing properties of natural tears.

Get relief from the irritated and dry eyes effectively with the use of Lubrex eye drops regularly. Buy it online at discounted prices at Tablet Tree.
Lubrex Eye Drops Uses

Sodium carboxymethylcellulose: It acts as an ocular lubricant which works by correcting osmolarity and pH distoration. It also restores the function of caliciform cells and also improves the metaplastic states of epithelia cells of conjunctiva. It has viscoelastic properties which provides lubrication to your eye surface.
Lubrex Eye Drops Composition

Sodium Carboxymethylcellulose……………………..0.5 % w/v

Stabilised Oxychloro Complex………………………..0.005% w/v
Lubrex Eye Drops Dosage

The recommended dose is as directed by the physician. Please consult your doctor and follow his or her recommendations. Please do not self medicate.
Lubrex Eye Drops Side Effects

The common side effects which can occur after taking this medicine are occasionally stinging, burning, red eyes and allergic reactions.

Other Information on Lubrex Eye Drops:
Pharmaceutical Form

Ophthalmic Solution
Precautions

It is for external use only and not for injection purposes
Do not touch the tip of container to any surface in order to avoid contamination
Do not use if the solution becomes cloudy or changes color
Discontinue the use of this medicine in case you experience eye pain, vision change, eye redness or irritation.
Inform your doctor in case you are pregnant or lactating

Overdose

There are no experiences of overdose by ophthalmic route.
Contraindications

This drug is contraindicated in patients who previously reported history of hypersensitivity to any of its components.
Package Content

One packet of Lubrex contains 10 ml eye drop

Manufacturer

Micro Labs Limited

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Hope above mentioned information will be helpful in deciding is breastfeeding safe for my daughter. Sorry for too much details but it is very difficult for my daughter to stop breastfeeding and crying too much. I know that breastfeeding is very important for a child for her good health. I don't want my daughter to stop breastfeeding.

May God bless you with all the joy and happiness!!

Hopefully, I will get helpful replies.
Thanks again,
Vipati

it is rare to get drug or even eye drop manufacturers to be open n transparent about use in nursing parents, the Association Of Breast Feeding Mothers runs a specialised Drugs in BreastMilk helpline and email service and also Facebook option with pharmacists who have a interest in lactation

It is rare for drug n drop trials to involve nursing parents hence theyl conclude "take at your own risk but make a informed choice"

My daughter is 4 in January n continues to nurse in spite of me being on several eye drops and other medications for other things as her overall health is benefitted by my milk so that is a balanced n controlled risk I have taken after seeking external support and guidance

Lea