Is Clindamycin (antibiotic) compatible with breastfeeding?

From the Guidelines

Clindamycin can be given with breast milk, but caution should be exercised due to the potential risk of gastrointestinal side effects in the infant. According to the most recent guidelines, breastfeeding patients with hidradenitis suppurativa who require systemic antibiotics, such as clindamycin, should be monitored closely for potential adverse effects in the infant 1. The guidelines suggest that clindamycin may increase the risk of GI side effects in the infant, although the medication is generally considered safe for use during breastfeeding 1.

When considering the use of clindamycin in breastfeeding patients, it is essential to weigh the potential benefits against the potential risks. The American Academy of Pediatrics classifies clindamycin as compatible with breastfeeding, but it is crucial to monitor the infant for potential side effects such as diarrhea, changes in stool, or thrush (oral fungal infection) 1.

Key points to consider when prescribing clindamycin to breastfeeding patients include:

• Monitoring the infant for potential gastrointestinal side effects
• Informing the healthcare provider about breastfeeding status when prescribing medications
• Continuing to nurse the baby as usual without needing to pump and discard milk or adjust the feeding schedule, unless otherwise advised by a healthcare provider
• Being aware of the potential risks and benefits of clindamycin use during breastfeeding, as outlined in the most recent guidelines 1.

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

• Clindamycin can be given to a nursing mother, but it is recommended to monitor the breast-fed infant for possible adverse effects on the gastrointestinal flora, such as diarrhea or candidiasis 2.
• 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.

From the Research

Clindamycin and Breast Milk

• There is limited information available on the use of Clindamycin during lactation, but some studies suggest that it can be used with caution 3, 4.
• Clindamycin is excreted into breast milk, but the amount is not well established 3.
• The American Academy of Pediatrics and other organizations consider Clindamycin to be compatible with breast feeding, but recommend monitoring the infant for potential side effects such as diarrhea, thrush, and rash 4.
• A study published in 2001 reviewed the use of anti-infective agents during lactation, including Clindamycin, and provided a table summarizing the pharmacokinetic properties of these agents in breast milk 3.
• Another study published in 2003 discussed the use of antibiotics during lactation and considered Clindamycin to be one of the safer options, although it recommended using the lowest effective dose and monitoring the infant for side effects 4.

Safety Precautions

• As with any medication, it is essential to weigh the benefits and risks of using Clindamycin during lactation and to consult with a healthcare provider before initiating treatment 3, 4.
• If Clindamycin is prescribed, the mother should be aware of the potential risks and monitor her infant for any signs of adverse effects, such as changes in stool or behavior 4.
• In general, the use of Clindamycin during lactation should be approached with caution, and alternative treatments should be considered if possible 3, 4.