What Antibiotics Can Be Used While Breastfeeding?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-31 10:00

What antibiotics can be used while breastfeeding?

Medicines designed to kill disease-causing bacteria are antibiotics. Invented at the beginning of the twentieth century, they have saved millions of lives. Over the past 20 years, these drugs have been widely used to treat a wide variety of diseases. There are 11 groups, which include more than 100 types of antibiotics of organic or synthetic origin.

However, there is still no universal remedy effective against all types of pathogenic bacteria. Therefore, the doctor selects an antibiotic against a specific pathogen, the drug dose and frequency of use, takes into account the side properties and contraindications. The correct choice of antibacterial drug is especially important during lactation, when the relationship between mother and child is most intimate.

Content:

• Indications for taking antibiotics during breastfeeding
• How does an antibiotic affect the body of infants?
• 3 groups of approved antibiotics for lactation
• List of prohibited drugs for breastfeeding
• 7 rules for choosing and taking antibiotics

Indications for taking antibiotics during breastfeeding

The main indication for taking drugs of this pharmaceutical group is a pronounced inflammatory process. Infection of the body with streptococcus or staphylococcus cannot be overcome without antibiotics. Breastfeeding cannot be a contraindication for such complex forms of infectious diseases.

Conditions in which antibiotics are used without fail:

• Gastrointestinal tract infections;
• Inflammation of the birth canal, as a result of complicated labor;
• Bacterial lesions of ENT organs, respiratory system;
• Infectious diseases of the kidneys, urinary system, pelvic organs.

Correctly selected drugs will help you quickly recover, bring your health back to normal. A significant disadvantage of treating a nursing mother with antibiotics is the effect of the components of the drug on the child's body through breast milk. Therefore, it is so important to choose an antibiotic for a lactating woman that is safe for the baby.

Before prescribing any medication, be sure to tell your doctor that you are breastfeeding. Many highly effective drugs have been developed against acute infections, but most of them are potentially dangerous for a breastfed baby.

How does an antibiotic affect the body of infants?

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If there is an urgent need to take an antibiotic during lactation, you need to minimize the risk of toxic effects on the baby. So that a nursing mother does not worry about the negative effect of the drug on children's health, it is necessary to take into account the peculiarities of the metabolism of such drugs.

• According to a study by the American professor D. Newman, presented in his article "Myths about breastfeeding," no more than 10% of the dose of the medicine taken by the mother gets into the body of an infant. According to the famous pediatrician, such an amount cannot cause significant harm to the baby due to the minimum concentration. Practitioners in pediatricians disagree with this view and warn of the dangers of using antibiotics during lactation.
• Modern drugs have a minimum time for the decomposition of the active substance and its excretion from the body. If for antibiotics taken in the last century it was several days or even weeks, then new generation drugs are removed in a few hours. You can find out this indicator in the instructions for use, section "Pharmacokinetics". Knowing the duration of the half-life of the active substance, you can calculate the time of taking the therapeutic dose so as not to combine it with feeding and not endanger the baby's health. For example, there is enough time before bedtime to take the medicine and meet the deadline before the morning feed.

• The American Federal Food Commission (FDA) classifies antibiotics for breastfeeding women as A-C. Group 1 of this classification includes drugs whose toxicity was tested on humans and animals. Means of groups 2 and 3 also showed an effective effect, but their tests were carried out exclusively on animals, and safety for humans was not tested. Russian pharmaceuticals do not use this classification, although FDA compliance is still indicated in the instructions for use.

In the instructions for the use of antibiotics approved for use during lactation, such a possibility is necessarily prescribed. These funds are taken as directed by a physician who has weighed the health benefits of the mother and the potential harm to the baby.

3 groups of approved antibiotics for lactation

The pharmaceutical industry offers several groups of antimicrobial agents approved for use by women while breastfeeding.

Approved drugs:

• Penicillins - the first antibiotics used in medicine, are most often used in the treatment of lactating and pregnant women, infants under one year old. Penicillins, which have a powerful antimicrobial effect, are Oxacillin, Ampicillin, Ticarcillin, Piperacillin, etc. Possible side effects for an infant whose mother is receiving treatment with such antibiotics are allergic reactions such as skin rash and diarrhea in 8% of children. According to a 2008 study by the American Academy of Pediatrics using Ampicillin as an example, the antibiotic dose in breast milk reaches less than 0.1% of the dose consumed by the mother. Such a concentration, in principle, is not capable of causing any significant reactions.
• Cephalosporins are officially recognized as safe, non-toxic medicines. These are drugs such as Cefazolin, Ceftibuten, Cefuroxime, Cefepim, Ceftriaxone. If they penetrate into breast milk, then this happens to a minimum, in a concentration that is completely safe for the baby. The lack of antibiotics of this group is the ability to influence the absorption of calcium and the blood formation of the child due to the provocation of dysbiosis by drugs in children with impaired synthesis of vitamin K.
• Macrolides are antibiotics from group C (according to the FDA classification), are used for allergies to other antimicrobial drugs. The macrolide group includes Erythromycin, Azithromycin, Midecamycin, Clarithromycin, Spiramycin. Prescribing macrolides can carry risks to the health of the mother and baby.

There are differences in international practice with these recommendations. For example, Ofloxacin (an antibiotic from the group of fluoroquinolones) is recognized as safe in the United States and is used for breastfeeding, and in the UK it is banned due to its effect on the growth of children and the state of inter-articular cartilage.

List of prohibited drugs for breastfeeding

Sometimes it happens that the disease and its treatment cannot be combined with breastfeeding. These are severe infections (meningitis, sepsis) or diseases that require specific antibiotic therapy. In this case, you have to interrupt breastfeeding for the course of treatment.

Drugs prohibited during lactation:

• Aminoglycosides - penetrate into milk in scanty amounts, however, even in such a minimal concentration, they can affect the kidneys, optic nerve, hearing organs, and the vestibular apparatus of the child. Such negative side effects are possessed by Gentamicin, Streptomycin, Kanamycin, Netilmicin, Amikacin - antibiotics that are prohibited for use during breastfeeding.
• Tetracyclines - drugs in this group require a particularly balanced approach, as they have many side effects. One of them is the so-called "tetracycline teeth" with characteristic damage to the tooth enamel, impaired growth of bone tissue. Drugs - Tetracycline, Doxycycline.
• Fluoroquinolones - Levofloxacin, Norfloxacin, Moxifloxacin, Ofloxacin, Ciprofloxacin, banned in Europe for use during lactation. In the United States, Ofloxacin is approved for use during breastfeeding.
• Lincosamides - Clindamycin, Lincomycin, which disrupt the child's digestive system.
• Sulfonamides - have a toxic effect on the baby's liver, are fraught with the appearance of nuclear jaundice. These are Biseptol, Sulfacil sodium, Streptocid, Etazol, Sulfadimezin, Phthalazol.

It is not necessary to urgently stop lactation. On the contrary, breastfeeding should be tried to be maintained and continued after recovery. With treatment with modern drugs, a woman will recover quickly enough. To maintain lactation, breast milk is expressed and disposed of without giving to the baby. It is permissible to feed the child with the mother's milk stored in advance. For this, it is stored in the freezer for no longer than a month.

After the course of treatment, the mother should refrain from feeding while the active substance is completely removed from the body. This period is indicated in the instructions for use of the product, usually it ranges from 2 to 7 days.

7 rules for choosing and taking antibiotics

Self-medication with antibiotics is unacceptable, and it is also very dangerous for a nursing mother! The selection of an effective drug for lactation can only be done by the attending physician. He must be sure to know that the woman is planning to keep breastfeeding, and to select the safest option.

Rules for choosing and taking antibiotics during lactation:

• Do not take any antibiotics if the baby is premature. Underweight babies react differently to any medication than full-term babies. There may be dangerous side effects for the weak body of the child.
• A nursing mother cannot take medications if the child has congenital malformations, a history of allergies. It is impossible to predict the reaction of a child's body with complex pathologies to the action of an antibiotic.
• When treating, the feeding regime must be taken into account. To reduce the concentration of the active substance in breast milk, the doctor prescribes the optimal time for taking the therapeutic dose.
• The age of the baby should be taken into account. Exchange processes in 1 month and 8-10 months are not the same. What is dangerous for a newborn may not do much harm to a one-year-old child.

For self-regulation of the amount of the drug in breast milk, nursing mothers follow simple recommendations:

• It is necessary to clarify in the instructions for use the time of the highest concentration of the drug in the blood and adjust the time of taking the drug so that this peak does not occur during lactation.
• Short courses of treatment with the most modern antibiotics should be used. Drugs with such properties cannot accumulate intensively in the blood and other tissues, and most likely will not cause an allergic reaction.
• The introduction of complementary foods will reduce the concentration of the antibiotic in the child's body. If the child is 6 months old, you can replace part of the breastfeeding with complementary foods in the form of vegetable and fruit purees, various cereals.

You cannot independently adjust the dosage of the antibiotic and the treatment regimen established by the doctor. Such actions entail a decrease in the effectiveness of the drug and a longer course of therapy.

In each specific case of prescribing antibiotics during breastfeeding, the potential risk to the health of the child and mother should be objectively assessed.

Author of the article: Alekseeva Maria Yurievna | Therapist

Education: From 2010 to 2016 Practitioner of the therapeutic hospital of the central medical-sanitary unit No. 21, city of elektrostal. Since 2016 she has been working in the diagnostic center No. 3.