Is cefdinir (Omnicef) safe to use during breastfeeding?

Cefdinir is Safe During Breastfeeding

Cefdinir is compatible with breastfeeding and does not require interruption of nursing. Following a single 600 mg dose, cefdinir was not detected in human breast milk, making it one of the safest antibiotic options for lactating mothers 1.

Evidence from FDA Drug Labeling

• The FDA-approved product labeling explicitly states that cefdinir was not detected in human breast milk after administration of single 600 mg doses 1.
• This absence of measurable drug transfer into breast milk eliminates concerns about infant exposure through nursing 1.

Supporting Evidence from Cephalosporin Class Safety

• Cephalosporins as a class are considered safe and compatible with breastfeeding, with most studies finding no fetal or infant harm when used appropriately 2.
• Short courses of cephalosporin antibiotics like cefdinir are commonly used in breastfeeding women with no evidence of harmful effects 3.
• The general principle for cephalosporins is that they appear in breast milk in minimal concentrations, and when present, have low oral bioavailability in infants 2.

Clinical Considerations

• No special precautions are needed - mothers can continue normal breastfeeding schedules without timing feeds around medication administration 1.
• The infant does not require monitoring for adverse effects given the absence of drug transfer into milk 1.
• One benign interaction to be aware of: If the infant receives iron-containing formula supplements, cefdinir can cause harmless reddish stools due to a nonabsorbable cefdinir-iron complex in the gastrointestinal tract 1, 4. This is not blood and resolves immediately upon drug discontinuation 4.

Practical Algorithm

1. Prescribe cefdinir at standard therapeutic doses without modification for breastfeeding status 1.
2. Counsel the mother that breastfeeding can continue normally without interruption 1.
3. Warn about red stools if the infant receives iron-fortified formula - this is harmless and not gastrointestinal bleeding 1, 4.
4. No need to pump and discard milk at any point during therapy 1.