----- Original Message -----
Sent: Saturday, April 03, 2004 5:12
AM
Subject: Re: [ozmidwifery] B12
Hi Rochelle:
I was surprised to read that Vit B12
administration would be contraindicated in pregnancy. So, I looked it up in
the 2003 PDR Nurses drug reference aand found it to be Category A or Category
C in doses that exceed the RDA (this is a USA publication so not sure
even now how RDA translates). Anyway Category A is interpreted as
controlled studies have shown no risk. Category C just means that risk cannot
be ruled out usually because "human studies are lacking" and states that
potential benefits may justify the potential risks. Do read the side
effects carefully. An IM preparation would most likely by Category
C because of the dosage.
It seems from what you describe that you have
some degree of malabsorption of Vit B12. Since this Vitamin is very important
for the synthesis of red blood cells and nervous tissue including
nucleoprotein and synthesis of myelin for both you, your lactating baby,
and your gestating baby I would agree with your GP and advise the IM or deep
SC injections. You GP is most likely concerned about the effect on you
should you suffer a postpartum haemorrhage or even a moderate blood loss at
birth with your low iron stores. You must weigh the benefits
against the risks. However, discuss this further with your GP if you
suffer from allergies (in particular cobalt as this is part of the Vit B12
molecule) as there can be significant allergic reactions ranging from itching
to anaphylactic shock. It would be usual for you to remain in the GP's office
for half an hour to an hour to safeguard this.
marilyn
----- Original Message -----
Sent: Thursday, April 01, 2004 3:55
PM
Subject: [ozmidwifery] B12
Hello,
what do midwives, nurses, naturopaths etc out
there think about having vitamin B12 shots at the end of my pregnancy. I
have always been told I have a B12 deficiency but have been previously
unaware of the actual levels until results almost a year ago showed a
reading of around 400 (anything over 250 is normal anything under 170 low
and inbetween is well inbetween.) I had bloods taken at 28 week pregnant -
now 31 and the results of my B12 came back at 212. My GP has recommended 2
intramuscular shots prior to the birth, which I was fine with until I got
the script filled and read the leaflet that says that B12 shots are
contraindicated in pregnancy and that B12 does cross the placenta. It says
that B12 should not be used to treat anemia in pregnancy. I am not anemic my
hemaglobin levels were fine and hadn't dropped much since the start of the
pregnancy however my iron store is down to 4. (it was 23 a year ago). For
this I am taking floradix and have upped my pregnancy multi and take it in
conjunction with ascorbic acid.
I guess I am in need of some direction, Firstly
is there an issue with the baby receiving B12 in such a way or at such a
level? and Is it really important for me to get my B12 levels up? If so for
me or the baby or both? What are the consequences if any of not having the
shots? Is anyone familiar with B12 issues?
By the way years ago I had a schillings test
which I think concluded that I was unable to efficiently absorb B12 from
food sources into the blood.
I am breastfeeding my 3 year old approx once a
day.The other thing the leaflet says is, "USE IN LACTATION"
Hydroxocobalamin is distributed into
breastmilk. Therefore it is not recommended for breastfeeding mothers unless
the expected benefits to the mother outweigh any potential risk to the
infant.
The prescription is Neo-Cytamen '1000'
(Hydroxocobalamin Chloride - Vitamin B12)
I will do some more research and further
discuss this with my care providers, but thought someone might have some
information or an opinion on this this, all responses will be greatly
appreciated.
Cheers
Rochelle.
