From the FDA Drug Label
Piperacillin is excreted in human milk; tazobactam concentrations in human milk have not been studied. No information is available on the effects of piperacillin and tazobactam on the breastfed child or on milk production Piperacillin is excreted in low concentrations in human milk. Caution should be exercised when PIPRACIL is administered to nursing mothers.
Safety during breastfeeding is uncertain. The FDA drug label states that piperacillin is excreted in human milk, but the effects on the breastfed child or milk production are unknown. Caution is advised when administering piperacillin/tazobactam to nursing mothers 1 2.
From the Research
Zosyn (piperacillin/tazobactam) is generally considered safe during breastfeeding, with only small amounts of the medication passing into breast milk and being poorly absorbed from the infant's gastrointestinal tract, making significant exposure to the nursing infant unlikely. The American Academy of Pediatrics classifies penicillins as compatible with breastfeeding 3. However, potential risks include modification of the infant's gut flora and possible allergic sensitization, though these are rare. If you need to take Zosyn while breastfeeding, you can continue to nurse your baby as normal. Monitor your infant for potential side effects such as diarrhea, thrush, or skin rash, although these are uncommon.
Some key points to consider when taking medications while breastfeeding include:
- The amount of medication that enters breast milk varies based on the maternal serum concentration and the pharmacologic properties of the medication 3
- Prescribers should use current, accurate resources, such as LactMed, to determine the safety of medications during breastfeeding 3
- Most commonly used drugs are relatively safe for breastfed babies, but some drugs, such as anticancer drugs, lithium, and oral retinoids, are contraindicated during breastfeeding 4
- The physician plays an extremely delicate role in assessing risks and benefits for both mother and child when it comes to medication use during breastfeeding 5, 6
It's essential to inform your doctor that you are breastfeeding when medications are prescribed to ensure the safest options are selected for both you and your baby. Always consult with your healthcare provider if you notice any concerning symptoms in your baby. The most recent and highest quality study on medication safety during breastfeeding, published in 2022, provides guidance on the safe use of medications during lactation 3.