Breastfeeding While Taking Antibiotics

Breastfeeding While Taking Antibiotics

With all the clamor going on across the world about viral outbreaks, growing antibiotic resistance, and rising healthcare costs, the thought of catching even a simple cold can be nerve-wracking, this is especially true if you have to take care of a baby.

Preventing illness through timely vaccination, avoiding exposure to infectious people, and proper, regular handwashing are ideal. Unfortunately, illness is inevitable even if you are fully vaccinated and have an iron-clad immune system. The very nature of all bacteria is to adapt and overcome available medications and treatments continually— after all, what doesn’t kill them makes them stronger.

Whenever you have a fever for several days or start showing symptoms such as runny nose, coughing or body malaise, you should seek consultation. Getting a prompt diagnosis and receiving medications is essential. This will treat the illness and limit the spread of infection to others around you. 

When you are prescribed medications to treat an illness, your doctor should always explain what the drug is for and how to take it. It is also vital to disclose to your doctor if you are breastfeeding, pregnant, or planning on either. This may have a bearing on the type of medication that he or she will prescribe.

Can antibiotics affect breast milk?

Though uncommon, some drugs can pass into breast milk and potentially enter your baby’s body if he or she nurses while you are taking medications. Rather than avoiding medications altogether, it would be wise to be aware of the ones that may pose an actual threat to your baby’s health.

While some drugs have the potential to be detected in breast milk, these drugs are not likely to impact milk production or quality significantly. The benefits of taking your medications as directed by your physician significantly outweigh the low or potential risks of the drug passing into breast milk. Stopping breastfeeding is considered more detrimental to a baby’s health and development than the concurrent use of antibiotics.

What antibiotics are safe to take while breastfeeding?

If you are ever prescribed antibiotics by a doctor, it is vital to take them on time and to completion regardless if your symptoms subside after a day or two. Taking antibiotics not only treats your infection effectively but prevents its recurrence and development of drug-resistant strains of bacteria, which would pose more of a threat to not only your health but the health of those around you.

During your consultation, you need to be open and honest about your symptoms as well as your breastfeeding status. The more information your doctor has, the more accurate your diagnosis and treatment plan will be.

For reassurance, shown below is a quick guide that lists some of the safest antibiotics to use while breastfeeding:

DrugBrand/Trade Names
Penicillin and derivativesAmoxil, Bactocill, Pipracil, Ticar
Penicillin with clavulanic acid
(Co-amoxiclav)
Augmentin, Clavulin
Cephalosporins
(all generations)
Keflex, Ceclor, Ceftin, Suprax, Cedax, Teflaro, Zinforo
Macrolides
(all types)
Erymax, Erythrocin, Klacid, Zithromax
MetronidazoleFlagyl
Fluconazole and other azole-type antifungalsDiflucan, Lotrimin, Cruex, Nystatin

How long after taking antibiotics, can I breastfeed?

Since dealing with an infection is of utmost importance, you should take your medications as soon as they are prescribed, as directed. The good news is that you do not need to stop breastfeeding while taking antibiotics. 

Oral and intravenously administered antibiotics would have little to no effect on your breast milk quality and quantity, so are considered safe to use while nursing or breast pumping. While topical creams and ointments with antibiotics are not systemically absorbed and are even less likely to enter breast milk if it is applied to the breast or nipple area, there is a chance that your baby may ingest the medication.

In the case of dermal infections that require topical treatment with an antibiotic, you should wait until the cream or ointment absorbs before allowing your baby to nurse from the affected breast. After one to two hours, you can bathe or gently wash the area with mild soap and water. 

To prevent prolonging the infection or transmitting it to your baby, the best option would be to use the other breast for nursing until the infection has cleared up. Bacterial infections of the skin can take one to two weeks to be cleared up while fungal infections may take up to one month to resolve.

Infections and conditions that typically require antibiotics to treat

Urinary tract infections (UTI)

UTIs are one of the most common infections that occur in women of all ages. It is often attributed to improper washing techniques, overuse of feminine washes, and inadequate hydration. Even another infection somewhere else in the body can increase the likelihood of getting a UTI. 

For busy breastfeeding mothers, UTIs can be a nuisance, but fortunately, they are easy to treat and are not life-threatening when caught early on. Treatment typically includes an antibiotic pill or tablet such as ciprofloxacin or trimethoprim-sulfamethoxazole (TMP-SMX) which should be taken for three to seven days, depending on your doctor’s orders. 

It is safe to take these medications while breastfeeding; however, sulfa-containing drugs such as TMP-SMX should not used if you or your child has glucose-6-phosphate (G6PD) deficiency.

Yeast infections

Vaginal yeast infections or oral yeast infections are most oftentimes caused by the opportunistic fungus called Candida albicans. This type of infection is also called thrush and can affect both a mother and her child.

Treatment for vaginal thrush includes oral medications, topical creams, and sometimes vaginal suppositories. These should be taken religiously until the infection is cleared up to prevent spread and worsening of itchiness as well as maintain adequate milk production.

Thrush on the breasts can cause oral thrush in babies who are breastfeeding and can lead to a vicious cycle of infection and reinfection between both a mother and child. 

Thrush of the breast is treated with antifungal cream and proper hygiene practices. Oral antifungals can be prescribed as well, especially if vaginal candidiasis is also present. Some topical antifungals are safe to apply to the breast and allow a baby to nurse from the same breast, though wiping the area clean or using the uninfected breast would be safer for both you and your child.

Skin infections

Skin infections such as a rash are usually treated with a topical antibiotic ointment or cream instead of a pill to prevent systemic side effects such as nausea and diarrhea. 

If topical medications are required to the breast or nipple area, you may need to temporarily stop breastfeeding from that breast. Using the unaffected breast for nursing while pumping from the affected breast may be required.

Acne

After giving birth and your estrogen levels start declining, you may notice pimples popping up. While this is transient, having acne as an adult can be embarrassing. Topical treatments such as medicated facial washes, toners, and creams clear up pimples and are safe to use while breastfeeding. 

If you have severe acne that is not responsive to non-prescription topical treatments, your doctor may prescribe oral antibiotics or prescription-strength topicals. These are safe to use while breastfeeding but are not if you are pregnant or planning on getting pregnant, so be sure to disclose those details to your doctor.

Pneumonia

Pneumonia can be life-threatening and highly infectious; therefore, it should be treated as soon as possible. Getting an accurate diagnosis is essential because bacteria, fungi, or viruses can cause pneumonia, and each pathogen must be treated with specific types of medications.

An antibacterial cannot cure pneumonia caused by a fungus, and neither antibacterial nor antifungal medications can treat viral pneumonia. Breastfeeding while taking your medications is allowable, but close contact with your infant or other household members may be necessary to prevent spreading the bug.

Peptic ulcer disease (PUD)

Chronic diseases like PUD can be an issue even before pregnancy and become cumbersome while trying to breastfeed. 

PUD can be triggered by ingesting substances like coffee or alcohol or by taking too many NSAIDs (nonsteroidal anti-inflammatory drugs) such as Tylenol (acetaminophen) or Advil (ibuprofen). However, the underlying cause is usually due to a strain of bacteria found in the stomach called Helicobacter pylori.

Most organisms can’t withstand the acidic environment of the stomach, however, H. pylori thrives in it. The bacteria latches onto the sides of the stomach lining and eats away at the tissue, causing craters and holes known as ulcers.

This can cause bleeding and abdominal discomfort and should be treated as soon as possible. Your doctor will likely prescribe a series of medications that include antacids to prevent corrosion of your stomach due to acid and some antibiotics to eradicate H. pylori from your stomach.

In the case of almost every disease and condition that requires antibiotic treatment, breastfeeding is still encouraged. The presence and potential effects of drugs that enter breastmilk, if any, do not outweigh the nutritional and immunologic benefits of breastfeeding. The general rule of thumb is that any drug that is safe for infants to take is deemed safe to take while breastfeeding.

Other examples of infections that need antibiotic treatment while you are breastfeeding include dental abscesses or infections.

The bottom line is that any infection you may have poses more of a threat to your baby’s health than the medications you would take to treat them, so the best thing you can do is to take your doctors advice and get well soon!

References

American Academy of Pediatrics. (2020). Breastfeeding and Medication. Retrieved from https://www.aap.org/en-us/Pages/Breastfeeding-and-Medication.aspx

Bar-Oz, B., Bulkowstein, M., Benyamini, L., Greenberg, R., Soriano, I., Zimmerman, D., … Berkovitch, M. (2003). Use of Antibiotic and Analgesic Drugs during Lactation. Drug Safety26(13), 925–935. doi: 10.2165/00002018-200326130-00002

Mathew, J. L. (2004). Effect of maternal antibiotics on breast feeding infants. Postgraduate Medical Journal80(942), 196–200. doi: 10.1136/pgmj.2003.011973

Seladi-Schulman, J. (2019, January 28). Cephalosporins: A Guide. Retrieved from https://www.healthline.com/health/cephalosporins

Whelan, C. (2018, October 29). What You Should Know About Thrush and Breastfeeding. Retrieved from https://www.healthline.com/health/parenting/thrush-breastfeeding

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