From the Guidelines
Breastfeeding mothers can safely take antibiotics such as amoxicillin, amoxicillin/clavulanic acid, azithromycin, and erythromycin, as these medications have been shown to have a low risk of adverse effects on the infant 1. When considering antibiotic use in breastfeeding mothers, it's essential to weigh the benefits of treating the maternal infection against the potential risks to the infant.
- The safety profile of an antibiotic depends on the infant's age, health status, and the specific antibiotic being used.
- Some antibiotics, such as tetracyclines, fluoroquinolones (ciprofloxacin), and sulfonamides, require caution, especially in premature infants or those under one month old 1.
- Most antibiotic courses are short-term (7-14 days), and mothers generally do not need to interrupt breastfeeding during treatment.
- The benefits of treating maternal infections typically outweigh the minimal risks to the breastfed infant.
- A recent study published in 2025 suggests that oral amoxicillin/clavulanic acid, erythromycin, and azithromycin are safe options for breastfeeding patients with hidradenitis suppurativa who require systemic antibiotics 1.
- Another study published in 2020 provides guidance on the use of antibiotics during breastfeeding, including the safety of amoxicillin, azithromycin, and cefuroxime 1. It's crucial for breastfeeding mothers to consult with their healthcare provider before taking any medication, as they can recommend the most appropriate antibiotic based on the specific infection being treated, the mother's medical history, and the infant's age and health status.
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 taken by a breastfeeding mother, but it is recommended to monitor the breast-fed infant for possible adverse effects on the gastrointestinal flora. An alternate drug may be preferred 2.
- The mother should be aware of the potential risks to the infant, such as diarrhea, candidiasis, or antibiotic-associated colitis.
- The benefits of breastfeeding should be weighed against the mother's clinical need for clindamycin and any potential adverse effects on the breast-fed child.
From the Research
Safe Antibiotics for Breastfeeding Mothers
The following antibiotics are considered safe for breastfeeding mothers to take:
- Penicillins 3, 4
- Aminopenicillins 3
- Clavulanic acid 3
- Cephalosporins 3, 4
- Macrolides 3
- Metronidazole 3, 4
- Cefotaxime 5
- Ceftriaxone 5
Antibiotics to Use with Caution
Some antibiotics should be used with caution or avoided during breastfeeding:
- Fluoroquinolones should not be administered as first-line treatment, but if they are indicated, breastfeeding should not be interrupted 3
- Tetracyclines should not be administered to pregnant or breastfeeding women 4
- Aminoglycosides should not be prescribed due to associated nephrotoxicity and ototoxicity 4
- Gyrase inhibitors are contraindicated for pregnant and breastfeeding women 4
Monitoring and Precautions
When taking antibiotics during breastfeeding, the following precautions should be taken: