Medications can be excreted in breast milk and thus be absorbed by the baby. This problem can get worse if the baby’s liver is not yet fully functioning in its detoxification function. On the other hand, treatment with antibiotics is often useful and protects mother and baby from serious infectious diseases.
Indications of antibiotics in pregnancy or lactation
However, certain bacterial diseases can occur more frequently during the breastfeeding period and require treatment. One example is mastitis puerperalis, an inflammation of the glandular tissue of the breast. It can be caused by bacteria and in this case can be treated with antibiotics. There can be great differences in the choice of antibiotics during breastfeeding. Not all antibiotics are considered absolutely harmless.
Which antibiotics are allowed during the lactation period?
With many drugs it is very difficult to prove that they cannot have any harmful effects. Studies on nursing mothers or pregnant women are strictly regulated for good reason. However, for certain antibiotics there is years of experience of their use in pregnancy.
These antibiotics are considered lower-risk substances. Penicillins and related substances, as well as cephalosporins, are considered to be particularly well-tried. Penicillins are among the oldest known antibiotics.
Their use in pregnancy and lactation has therefore been tried and tested for years. Other proven agents are erythromycin and azithromycin. Clindamycin, metronidazole and certain carbapenems are known as second choice drugs.
These are also among the lower-risk substances, although there is less experience with their use. In addition, substances that need to be taken as rarely as possible, for example only once a day, can be beneficial. The method of administration is also important.
Many antibiotics are taken in tablet form. But there are also antibiotic eye drops, for example. These are usually harmless, as they are only absorbed by the body in very small quantities.
If in doubt, a doctor or pharmacist should always be consulted. In addition, large databases have been set up in which medicines are listed according to their risk potential for the child. Many of these databases can also be accessed via the Internet.
Which antibiotics are contraindicated in lactation?
Not all antibiotics can be used risk-free during breastfeeding. Especially substances that have shown an increased risk for the child in animal experiments are only used under strict control. In addition, there is often insufficient experience for use in humans.
For some antibiotics, therefore, better-tested alternatives are recommended. Examples of antibiotics that should only be used with hesitation are co-trimoxazole or fluoroquinolones. However, if no proven alternative is available, these drugs can also be taken while breastfeeding.
Better tested medications are still preferable. The use of tetracyclines and aminoglycosides should also be carefully considered. If a proven alternative exists, it should be preferred in any case. If in doubt, a doctor or pharmacist should always be consulted. Databases facilitate the control of a particular drug.