From the Guidelines
Breastfeeding mothers diagnosed with Strep throat should continue breastfeeding while undergoing antibiotic treatment. The recommended antibiotic treatment for a breastfeeding mother with Strep throat is penicillin or amoxicillin, typically at a dose of 250-500 mg orally every 8-12 hours for 10 days 1. For individuals with penicillin allergy, alternative options such as cephalexin, cefadroxil, clindamycin, azithromycin, or clarithromycin may be considered, with specific dosing regimens as follows:
- Cephalexin: 20 mg/kg/dose twice daily (max = 500 mg/dose) for 10 days 1
- Cefadroxil: 30 mg/kg once daily (max = 1 g) for 10 days 1
- Clindamycin: 7 mg/kg/dose 3 times daily (max = 300 mg/dose) for 10 days 1
- Azithromycin: 12 mg/kg once daily (max = 500 mg) for 5 days 1
- Clarithromycin: 7.5 mg/kg/dose twice daily (max = 250 mg/dose) for 10 days 1. Breastfeeding can continue as usual, as these antibiotics are considered safe for use during lactation, and the risk of transmission of Strep throat to the infant through breast milk is low. Key points to consider include:
- Accurate diagnosis of Strep throat is crucial to prevent unnecessary antibiotic use and potential development of antimicrobial resistance 1
- Antibiotic treatment should be tailored to the individual's specific needs and medical history, including any allergies or sensitivities 1
- Breastfeeding mothers should be aware of the potential for side effects from antibiotic treatment and monitor their infant for any signs of adverse reactions 1.
From the Research
Care Instructions for a Mother Diagnosed with Streptococcal Pharyngitis (Strep Throat) while Breastfeeding
- The majority of antibiotics used to treat Streptococcal pharyngitis are considered compatible with breastfeeding 2, 3, 4.
- Penicillins, aminopenicillins, clavulanic acid, cephalosporins, macrolides, and metronidazole are considered safe for use during lactation 2.
- Amoxicillin/clavulanic acid and cefuroxime may also be safe during lactation, although larger studies are needed to confirm these findings 3.
- The use of analgesics such as paracetamol (acetaminophen), low-dose aspirin, and short-term treatment with NSAIDs, codeine, and morphine are considered compatible with breastfeeding 2, 5.
- It is recommended to use the lowest effective maternal dose of antibiotics and analgesics to minimize infant exposure 5.
- Breastfeeding can be continued during treatment with antibiotics and analgesics, but the infant should be monitored for possible adverse effects 2, 5.
- The benefits of breastfeeding should be weighed against the potential risks of antibiotic and analgesic use, and decisions should be based on accurate and up-to-date information 2.
Antibiotic Treatment
- Amoxicillin administered once daily is not inferior to other dosages of the same antibiotic or penicillin V in the treatment of streptococcal pharyngitis 6.
- The effectiveness of antibiotic treatment should be monitored, and the treatment regimen should be adjusted as needed to ensure the mother's recovery and minimize the risk of adverse effects to the infant 6.