Is doxycycline (tetracycline antibiotic) safe during breastfeeding?

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Last updated: May 5, 2025View editorial policy

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From the Guidelines

Doxycycline should be used with caution during breastfeeding, and its use should be limited to a short course of 3 weeks or less, as recommended by the most recent guidelines 1. If you are breastfeeding, alternative antibiotics such as penicillins, cephalosporins, or macrolides are preferred options. The concern with doxycycline stems from its ability to bind to calcium in developing teeth, potentially causing dental staining and enamel hypoplasia in infants. Additionally, it can theoretically affect bone growth, though the amount that transfers into breast milk is small. Some key points to consider when using doxycycline during breastfeeding include:

  • Monitoring your infant for potential side effects such as thrush (oral candidiasis) or diaper rash due to disruption of normal bacterial flora.
  • Discussing your specific situation with your healthcare provider to weigh the benefits of treatment against potential risks to your breastfeeding infant.
  • Being aware that doxycycline is excreted into breast milk at low levels, but the extent of absorption by nursing infants is unknown 1.
  • Considering the recommendations from the European Respiratory Journal, which suggests that doxycycline is compatible with breastfeeding in short treatments (3–4 weeks) 1. However, the most recent guidelines from the Journal of the American Academy of Dermatology recommend limiting the use of oral doxycycline in breastfeeding patients with HS to 3 weeks and without repeating courses 1.

From the FDA Drug Label

Tetracyclines are excreted in human milk; however, the extent of absorption of tetracyclines, including doxycycline, by the breastfed infant is not known Short-term use by lactating women is not necessarily contraindicated; however, the effects of prolonged exposure to doxycycline in breast milk are unknown Because of the potential for serious adverse reactions in nursing infants from doxycycline, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Breastfeeding and doxycycline use requires caution. The drug is excreted in human milk, but the extent of absorption by the infant is unknown.

  • Short-term use may not be contraindicated, but
  • prolonged exposure effects are unknown. A decision to discontinue nursing or the drug should be made, considering the drug's importance to the mother 2.

From the Research

Breast Feeding and Doxycycline

There is no direct evidence in the provided studies regarding the use of doxycycline during breastfeeding.

  • The studies primarily focus on the use of doxycycline as a treatment for various infections, including sexually transmitted infections, and its effectiveness compared to other antibiotics 3, 4, 5, 6, 7.
  • None of the studies mention breastfeeding or the safety of doxycycline use during lactation.
  • Therefore, there are no research papers to assist in answering this question regarding the safety of doxycycline use during breastfeeding.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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