From the Guidelines
Clindamycin should be used with caution in breastfeeding patients due to the potential risk of GI side effects in the infant. When considering the use of clindamycin in breastfeeding patients, it is essential to weigh the benefits of treatment against the potential risks to the infant. According to the North American clinical practice guidelines for the medical management of hidradenitis suppurativa in special patient populations 1, caution should be exercised when using oral clindamycin in breastfeeding patients. Some key points to consider when using clindamycin in breastfeeding patients include:
- Monitoring the infant for potential GI side effects, such as diarrhea or abdominal distress
- Discussing the risks and benefits of treatment with a healthcare provider
- Considering alternative antibiotics that may be safer for use during breastfeeding, if possible
- Being aware that the risk of GI side effects in the infant may be increased with clindamycin use, as suggested by the guidelines 1. It is crucial to prioritize the health and well-being of both the mother and the infant when making decisions about medication use during breastfeeding, and to consult with a healthcare provider for personalized guidance.
From the FDA Drug Label
Nursing Mothers Limited published data based on breast milk sampling reports that clindamycin appears in human breast milk in the range of less than 0.5 to 3. 8 mcg/mL. Clindamycin has the potential to cause adverse effects on the breast-fed infant's gastrointestinal flora. If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred Monitor the breast-fed infant for possible adverse effects on the gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for clindamycin and any potential adverse effects on the breast-fed child from clindamycin or from the underlying maternal condition
- Clindamycin use in breast-feeding: Clindamycin can be used with breast-feeding, but it is recommended to monitor the breast-fed infant for possible adverse effects on the gastrointestinal flora, such as diarrhea or candidiasis 2.
- Precautions: An alternate drug may be preferred, and the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for clindamycin.
From the Research
Clindamycin and Breastfeeding
- Clindamycin is considered relatively safe for use during breastfeeding, as the risk to infants is relatively low 3, 4.
- The majority of antibiotics, including clindamycin, have not been shown to cause adverse effects when used during lactation 4.
- However, it is recommended to monitor breastfed infants closely when their mothers are receiving clindamycin or any other antibiotic for a skin and soft tissue infection 3.
- Clindamycin has been extensively used in the therapy of obstetric and gynecologic infections for over 20 years, but its use during breastfeeding has not been specifically studied in detail 5.
Safety Precautions
- Although clindamycin is considered safe, it is essential to be aware of the potential side effects, such as pseudomembranous colitis, which is an uncommon problem that responds well to treatment 5.
- Clindamycin hypersensitivity is not common, but delayed-type allergic reactions can occur, and patch tests may be useful in diagnosing suspected clindamycin allergy 6.
- Hospital-wide restriction of clindamycin has been shown to decrease the incidence of Clostridium difficile-associated diarrhea and can lead to cost savings 7.