Is cefdinir compatible with breastfeeding for a lactating mother, and are any infant precautions needed?

Cefdinir is Compatible with Breastfeeding

Cefdinir is safe to use during breastfeeding, as it is not detected in human breast milk following standard dosing. 1

Direct Evidence from FDA Drug Label

The FDA-approved product labeling for cefdinir explicitly states that following administration of single 600 mg doses, cefdinir was not detected in human breast milk. 1 This represents the highest quality evidence available—direct measurement showing no drug transfer to breast milk.

Supporting Evidence from Cephalosporin Class Safety

• Cephalosporins as a class are classified as "compatible" with breastfeeding according to multiple international guidelines, including the European Respiratory Society. 2
• β-lactam antibiotics, which include all cephalosporins like cefdinir, are considered safe during lactation by the American Academy of Pediatrics and other medical societies. 2
• Most studies demonstrate that cephalosporin antibiotics have low presence in breast milk and are safe to use during lactation. 2

Practical Clinical Recommendations

• Breastfeeding can continue normally without interruption when the mother is taking cefdinir. 1
• No need to pump and discard breast milk, time doses around feeding schedules, or monitor the infant for specific drug-related effects. 1
• The standard monitoring recommendation for any antibiotic applies: observe the breastfed infant for mild gastrointestinal effects (diarrhea, changes in stool pattern) due to potential alteration of intestinal flora. 2

Important Caveat: Red Stools Are Benign

If the infant is receiving iron-fortified formula or iron supplements, red-colored stools may appear. 1, 3 This is a benign drug-food interaction where cefdinir forms a nonabsorbable complex with ferric ions in the gastrointestinal tract, creating a reddish stool color. 1, 3 This is not gastrointestinal bleeding and requires no intervention beyond reassurance. 3 The red stools resolve within 48 hours of discontinuing cefdinir. 3 Importantly, iron-fortified infant formula (2.2 mg elemental iron/6 oz) does not significantly affect cefdinir pharmacokinetics and can be administered concomitantly. 1

Algorithm for Clinical Decision-Making

1. Prescribe cefdinir at standard doses without modification for breastfeeding mothers. 1
2. Counsel the mother that cefdinir is not detected in breast milk and breastfeeding should continue normally. 1
3. Warn about red stools if the infant receives iron-containing products—this is harmless and expected. 1, 3
4. Monitor the infant for routine gastrointestinal effects (mild diarrhea) as with any antibiotic, not specific to cefdinir. 2