What consequences does taking antibiotics have for my baby?
Many antibiotics that are taken during breastfeeding have only a very mild, often unnoticeable effect on the baby. This is especially true for proven antibiotics, which are classified as rather harmless. The consequences for the baby depend on several factors.
Not all medicines get into the breast milk and thus into the baby’s food in the same quantity. The timing, frequency and quantity of intake are also important. In addition, the infant’s metabolism can differ from that of an adult.
Especially the liver may not be fully mature in its work. It performs important detoxification functions and is central to the metabolism of many antibiotics. As a result, the breakdown of many antibiotics in infants is often different from that of adults.
One of the most common adverse effects of antibiotics on the infant is thinner stools, rarely diarrhoea. However, this occurs relatively rarely and is usually only temporary. Antibiotics that are excreted with breast milk first reach the infant’s intestines.
They can thus have an influence on the child’s intestinal flora. Particularly in the first few months, the intestinal flora is not yet mature and only develops slowly. There are indications that a disturbance of the infantile intestinal flora can lead to health problems in the child’s later life.
Also an increased BMI, i.e. a trend towards overweight, has already been observed. For some antibiotics it is known that they are not harmless for children. For example, antibiotics from the group of fluoroquinolones can cause cartilage damage, while gentamicin is suspected of damaging the ears.
However, this applies to the direct intake of the antibiotic by the child. Both drugs, however, only pass into breast milk in very small quantities, so that such side effects are virtually ruled out. These drugs can therefore also be taken by the mother while breastfeeding. However, the risks should be weighed up even more carefully than is already the case.
Does the antibiotic pass into the breast milk?
At least in traces, any medicine taken can enter the breast milk. However, there are big differences in the quantities in which this can happen. Two factors are particularly important here.
For penicillin G, for example, the relative dose, i.e. the proportion of the mother’s daily dose that is absorbed by the baby, is given as less than 1%. – The first factor is the plasma concentration of the unbound antibiotic in maternal blood. This depends on the time of administration, the amount administered and absorbed, the metabolism and excretion of the drug.
Not all antibiotics float freely in the blood. Often they are only present bound to the body’s own proteins, which makes it even more difficult to transfer them into breast milk. – The second factor is the nature of the antibiotic itself.
While smaller molecules enter breast milk more easily, the fat solubility of larger molecules is the most important factor. Usually only a very small proportion of the antibiotic ingested passes into breast milk. Cystitis is a widespread use of antibiotics.
It is not always necessary to take antibiotics. Particularly in the case of mild symptoms, without fever or missing signs of a serious illness, a purely symptomatic treatment by the doctor can be recommended. However, this is not always sufficient.
If antibiotics are used for the treatment of cystitis during breastfeeding, penicillins are recommended, for example, as they are also used for non-nursing adults. Dental inflammation should be treated immediately. This may require the intake of an antibiotic.
Here too, antibiotics from the group of penicillins are a means of choice. Most penicillins, such as the widely used amoxicillin, are among the well tested and proven antibiotics used during breastfeeding. However, often an antibiotic is not absolutely necessary.
If in doubt, the dentist should therefore be informed about breastfeeding. This will enable him or her to plan further therapy better. Acute bronchitis is an inflammation of the bronchi, i.e. the airways in the lungs.
The majority of acute bronchitis is caused by viral pathogens. Since antibiotics against viruses are not sufficiently effective, it is not advisable to administer them. Bacterial infections occur primarily in the case of a pre-existing, usually known disease of the lung.
If a bronchitis is caused by bacteria, the choice of antibiotic depends mainly on the pathogen. Some pathogens of bacterial bronchitis require the use of special antibiotics such as Clarithromycin. This can be used in lactation if there is a medical benefit.
Another widespread use of antibiotics is the treatment of angina or tonsillitis. Again, not all tonsillitis or diseases perceived as such need to be treated with antibiotics. Acute tonsillitis in particular can be caused by viruses.
In this case, antibiotics are usually not recommended. However, antibiotics are often used, especially after evidence of a bacterial infection. This is usually a drug from the group of penicillins or cephalorsporines.
Both groups have been tried and tested for use in nursing mothers and are used as first-choice drugs. Inflammation of the middle ear often occurs following an infection of the airways. The basic therapy consists mainly of basic measures such as drinking a lot and pain therapy.
Antibiosis is therefore not always necessary. However, especially in serious or complicated cases, antibiotics are often useful and prevent serious secondary damage. Amoxicillin is also the treatment of choice for middle ear inflammation.
It is considered to be well proven and is the drug of choice during breastfeeding. Mastitis can also occur during breastfeeding. An inflammation of the mammary glands occurring during breastfeeding is called mastitis purpuerperalis.
Here, too, basic measures are initially in the foreground. These include regular emptying of the breast with subsequent cooling or painkillers. Antibiosis may be necessary, especially if the inflammation of the breast has existed for more than two days.
Penicillins or cephalosporins are again the drugs of choice during pregnancy. Lyme disease, often simply called Lyme disease, is a complex and long-term disease. It is caused by bacteria from the so-called Borrelia – burgdorferi – complex.
The disease usually progresses in several phases. Depending on the phase, a different treatment may be necessary. Especially at the beginning of a borreliosis, amoxciillin can be given as a well-proven medication in the lactation period.
In later stages other antibiotics are also used. Cephalosporins are one example. They are also considered to be well tested drugs in the lactation period.
Alternatively, it may be necessary to take doxycycline. In principle it is also possible to continue breastfeeding while taking doxycycline. In general, Lyme disease is a serious illness which should be treated by a doctor.
All articles in this series:
