From the Guidelines
Amoxicillin is considered safe for use during breastfeeding, with limited human data supporting its safety, as stated in the 2025 North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations 1. The medication passes into breast milk in small amounts, but it is not expected to cause harm to most nursing infants.
- The typical adult dose of amoxicillin ranges from 250-500 mg three times daily or 500-875 mg twice daily, depending on the infection being treated.
- Some infants may experience temporary side effects such as diarrhea or changes in the gut microbiome, but these are usually mild and resolve on their own.
- If your baby develops a rash, severe diarrhea, or seems unusually fussy after you start taking amoxicillin, contact your healthcare provider. The benefits of treating your infection properly with amoxicillin typically outweigh any minimal risks to your nursing infant, as suggested by the guidelines 1. Always inform your healthcare provider that you are breastfeeding when any medication is prescribed.
- It is essential to note that amoxicillin/clavulanic acid is specifically suggested for use in breastfeeding patients with hidradenitis suppurativa who require systemic antibiotics, according to the 2025 guidelines 1.
- The safety profile of amoxicillin makes it a preferred choice over other antibiotics during breastfeeding, as supported by the limited human data and expert opinion 1.
From the FDA Drug Label
Penicillins have been shown to be excreted in human milk. Amoxicillin use by nursing mothers may lead to sensitization of infants. Caution should be exercised when amoxicillin is administered to a nursing woman.
Amoxicillin use during breastfeeding: Amoxicillin is excreted in human milk, and its use by nursing mothers may lead to sensitization of infants. Therefore, caution should be exercised when amoxicillin is administered to a nursing woman 2.
From the Research
Amoxicillin and Breastfeeding
- The use of most antibiotics, including penicillins, is considered compatible with breastfeeding 3
- Amoxicillin is a type of penicillin, and its use during lactation is generally considered safe 3, 4
- A study evaluating the safety of amoxicillin/clavulanic acid during lactation found that the rate of adverse effects in infants was higher than with amoxicillin alone, but all effects were minor and self-limiting 4
- Another study found that most antibiotics, including amoxicillin, are suitable for use during breastfeeding, but the pharmacokinetic profile of each drug must be considered to ensure the safety of the infant 5
Safety Precautions
- It is essential to consider the pharmacokinetic factors that interfere with the passage of antibiotics into breast milk and the toxicological implications of absorption by the infant 5
- The American Academy of Pediatrics provides guidelines for the safe use of drugs during lactation, and medical professionals should consult these guidelines when making decisions about maternal medication use during breastfeeding 3, 4
Allergy Considerations
- Approximately 10% of the US population reports an allergy to penicillin, but clinically significant IgE-mediated or T lymphocyte-mediated penicillin hypersensitivity is uncommon (<5%) 6
- The rate of IgE-mediated penicillin allergies is decreasing, and cross-reactivity between penicillin and cephalosporin drugs occurs in about 2% of cases 6
- A study found that physician-diagnosed allergic reactions to beta-lactam antibiotics based on patient examination at the time of the reaction is more accurate than patient history alone, but still overestimates the rate of possible true allergy in 66% of patients 7