If you’ve been prescribed an antibiotic while breastfeeding, you may be concerned about its safety. Will the medication pass into your breast milk? Is it safe for your baby? If the particular antibiotic you’ve been prescribed is not safe, are there any safer alternatives?
All of these questions can create a ton of stress. That’s understandable. Keep reading for answers to your questions.
In most cases, antibiotics are safe for breastfeeding parents and their babies.
“Antibiotics are one of the most common medications mothers are prescribed, and all pass in some degree into milk,” explains the Academy of American Pediatrics (AAP). At the same time, the AAP adds: “In general, if the antibiotic would be administered directly to a premature infant or a neonate, then it is safe for the mother to take during breastfeeding.”
So what does this mean for you and your breastfeeding baby?
First, it’s important to keep in mind how medications generally work when you’re breastfeeding.
As the Mayo Clinic explains, the majority of drugs that become present in your bloodstream will also be present in your breast milk. However, the amount in your milk is usually lower than the amount in your blood, and most medications “pose no real risk to most infants.”
However, the Mayo Clinic also notes that there are exceptions, and as such, every medication you take — including antibiotics — should be cleared with your baby’s pediatrician.
In addition to the medication itself, there are other factors to keep in mind, including how old your baby is. Exposure to antibiotics will pose a greater risk to premature babies and newborns, as opposed to older babies and toddlers, explains the Mayo Clinic.
And again, if your baby could safely take the antibiotic, it’s likely safe to take it while breastfeeding.
If you’re considering taking an antibiotic that’s not considered safe for your baby, you’ll need to decide how important it is for you to take the medication.
Are there safe alternatives? How long do you have to be on the medication? Can you “pump and dump” and then resume breastfeeding?
This question is often considered on a case-by-case basis depending on your baby’s age, weight, and overall health — and always in consultation with your baby’s pediatrician and your prescribing provider.
However, the Mayo Clinic lists several antibiotics that are generally considered safe for breastfeeding women, including:
- penicillins, including amoxicillin and ampicillin
- cephalosporins, such as cephalexin (Keflex)
- fluconazole (Diflucan) — this is not an antibiotic but a common antimicrobial used to treat fungal infections
If you’re considering taking an antibiotic that’s not listed above, your best bet is to talk to your baby or child’s pediatrician. Chances are that the antibiotic is safe, or that there’s a safe alternative.
Apart from the concern that an antibiotic might harm your baby’s well-being, there are other possible concerns regarding antibiotic use by breastfeeding moms.
Antibiotics work by killing bacteria in your body — both the bacteria that are causing you harm and the “good” bacteria that keep you healthy. As such, antibiotics can cause certain uncomfortable situations for both moms and babies.
Stomach upset and fussiness in babies
Sometimes moms report that their babies have an upset stomach after they take antibiotics. This may be because antibiotics may deplete the “good” bacteria in your baby’s gut.
Keep in mind that this effect is usually short lived, not harmful, and not a given. Also, keep in mind that breast milk is great for your baby’s gut health, so it’s important to continue breastfeeding.
You can consider giving your baby probiotics to remedy this problem, but it’s important that you consult your baby’s medical provider before doing so.
Sometimes — again, because antibiotics can decrease the number of “good” bacteria in your system that keep other microorganisms in check — you and/or your baby may develop thrush, a fungal infection usually caused by Candida albicans, a fungal yeast.
Overgrowth of Candida albicans can cause very uncomfortable symptoms in both moms and babies. Babies may experience an upset stomach, diaper rash, and white coating on their tongue and mouths. The mother may experience nipple pain (often described as stabbing or like “glass in the nipples”) and red, shiny nipples.
Treatment for thrush usually involves antifungal medication for both moms and babies. But prevention is key. If you’re taking an antibiotic, it’s advised that you take a probiotic to keep your gut bacteria happy and balanced.
If you’re prescribed an antibiotic, first consult your baby’s pediatrician. Things you may want to ask include:
- Is this medication safe for my baby?
- Are there any side effects that my baby may experience?
- Should I give probiotics to my baby?
If you’re told that antibiotics aren’t safe for your baby — don’t worry. There are usually alternatives.
- Ask your practitioner if there are alternative, breastfeeding-friendly antibiotics.
- Ask if a lower dose of the antibiotic could work.
- Ask how long you’ll need to take the medication and how long it stays in your system.
If you feel concerned that your pediatrician or doctor isn’t taking your concerns seriously, you can also contact another provider for a second opinion. Not all medical providers are knowledgeable about breastfeeding, so feel free to seek out one who is.
If you end up needing to take a medication that is unsafe for your baby, try not to worry too much.
Sometimes taking an antibiotic that’s contraindicated for breastfeeding is important for your own health, and you should not feel guilty if this is the case. Your baby needs a healthy mama more than anything else, so do what you need to do to stay healthy.
If you can’t breastfeed while taking the antibiotic, make sure to pump and dump your milk on a regular schedule to maintain your milk supply. And of course, make sure your baby is fed by alternative means while you wait. You should be able to resume breastfeeding once your body clears the antibiotic.
Another resource for you to consult is
Additionally, you may consider contacting the Infant Risk Center, which provides evidence-based information about breastfeeding and medication, including a hotline to answer your questions.
For further help, consider contacting a lactation consultant, who may be able to counsel you on the pros and cons of taking a particular antibiotic. They may be able to guide you to further resources to help you make your decision.
It’s hard enough to be faced with an illness or any kind of medical condition that requires antibiotics. And having to fret over whether the antibiotic you’re prescribed is safe for you to take as a breastfeeding parent can certainly add to the stress.
The antibiotic you’ve been prescribed is likely totally fine. Kids are prescribed antibiotics frequently in childhood, so it’s known that most antibiotics are safe for young people, including babies. Also, if you’re prescribed an antibiotic that’s contraindicated for breastfeeding, you usually have alternatives.
Sometimes asking for alternatives and questioning your doctor’s advice can feel like a difficult conversation to navigate. Pumping and dumping is an option — and it can work out fine when necessary — but it’s not always the answer. It’s understandable why many breastfeeding moms don’t prefer that option.
Don’t be afraid to advocate for yourself, seek out good, evidence-based information, educate yourself about breastfeeding and medicine usage, and seek second opinions when necessary.
Lactation consultants and breastfeeding peer counselors can help you make sense of what you’re learning and help you work through these difficult conversations with your provider.
In the end, whatever happens, you and your baby will get through it just fine.