Pregnant and nursing women have a lot of questions, and Bethany Kotlar has a lot of answers.
Kotlar is the program coordinator for MotherToBaby Georgia, a free, confidential information resource within the Center for Maternal Substance Abuse and Child Development (MSACD) in the medical school. Pregnant or breastfeeding women or their clinicians can call, text, live chat, post on Facebook, or tweet questions about a wide range of concerns. Kotlar fields inquiries about medications, vaccines, smoking, drinking, household cleaning products, herbal supplements, and more.
One would think most of her time would be taken up by Zika questions these days, but those calls peaked in June and July and have actually tapered off. "The drop is not, unfortunately, because the risk is gone — it's still mosquito season in South Florida," says Kotlar, who herself was infected with Zika this summer while vacationing in the Caribbean. "But as we head into fall, people have stopped paying as much attention to it."
MotherToBaby Georgia was established three years ago by Claire Coles (psychiatry), director of MSACD. It joined about a dozen other MotherToBaby sites, which are services of the Organization of Teratology Information Specialists. Its purpose is to provide up-to-date, evidence-based information about exposures during pregnancy and breastfeeding. A 2015 RSPH alumna, Kotlar came on board seven months ago and has spent a good deal of her time trying to get the word out about the service, touting MotherToBaby Georgia everywhere from ob/gyn conferences to groups of refugee moms.
Her efforts are paying off, and she's getting more and more inquiries, particularly from young women. Some questions come up again and again — Can I drink while I'm breastfeeding? (Yes, but only if you wait until the alcohol clears your breast milk, which very generally takes 2 to 2.5 hours per drink.) Can I continue to take my antidepressant, antianxiety, or antipsychotic medication? (Each case is different, and it's important to weigh the risks of the medication with the risks of not treating a mental health issue.) Can I smoke pot while I'm pregnant? (Not a good idea. It could be linked with premature birth and low birthweight, among other issues.)
Other questions can throw Kotlar for a loop, like the one she got recently from a clinician whose patient wanted to use colloidal silver (a liquid form of silver) as a homeopathic remedy for a ringworm infection. Stumped, Kotlar put the question to a MotherToBaby listserv of teratologists across the globe and found several clinicians who had seen it in their practice (Best to stay away from using colloidal silver while pregnant because its effect on the fetus is unknown.)